The dangers of multiple abortions

Multiple abortions can cause great harm to women's uterus. The reason why many women suffer from infertility is that they have had too many abortions before, which makes their endometrium thinner and thinner, so they can no longer get pregnant. Even after getting pregnant, there is a risk of habitual miscarriage, which means they cannot get pregnant successfully. Therefore, do not have abortions frequently.

Indications

1) Healthy women aged 18-40 years who are diagnosed with normal intrauterine pregnancy (last menstrual amenorrhea ≤ 49 days) and voluntarily request to use medication to terminate pregnancy; 2) High-risk candidates for abortion, such as those with reproductive organ malformations (except rudimentary uterine horn), severe pelvic malformations, extremely tilted uterus, cervical dysplasia or tough uterus, scarred uterus, and multiple artificial abortions. (Note: Even if these patients choose medical abortion, they still have high-risk factors for medical abortion. The failure rate of medical abortion and the chance of post-abortion bleeding are higher than those of patients without high-risk factors); 3) Those who have concerns or fears about surgical abortion.

Contraindications

1) Contraindications of mifepristone: endocrine diseases such as adrenal glands, diabetes, thyroid gland, abnormal liver and kidney function, history of skin itching during pregnancy, history of blood diseases and vascular thrombosis, and tumors related to steroid hormones

2) Contraindications of prostaglandins: cardiovascular diseases, such as mitral stenosis, hypertension, hypotension, glaucoma, gastrointestinal dysfunction, asthma, epilepsy, etc., or those who are allergic to prostaglandins;

3) Those with allergic constitution or severe vomiting during pregnancy;

4) Anemia, hemoglobin level of 100g/L or below;

5) Pregnant women with an IUD;

6) Ectopic pregnancy or hydatidiform mole;

7) Smokers who smoke more than 10 cigarettes a day or drink alcohol;

8) Those who frequently travel on business, come to Beijing from other places, live far away from medical institutions, and cannot receive timely medical treatment and follow-up;

9) Inflammation of the reproductive tract, such as vaginitis, acute suppurative cervicitis or subacute cervicitis, acute and chronic pelvic inflammatory disease, sexually transmitted diseases, etc., which have not been treated.

Pre-medication treatment

1) The doctor should explain the medication method, efficacy and possible side effects to the recipient, and the recipient can make a voluntary choice; 2) Physical examination and testing are the same as vacuum aspiration; 3) The pros and cons of medical abortion should be explained to pregnant women, and they can make a natural choice.

Directions

Mifepristone: Generally, the first dose is given in the outpatient clinic, and the rest can be taken home by the patient; Prostaglandin: Patients are required to come to the hospital for medication and stay in the hospital for observation, take it on an empty stomach on the morning of the third day, or insert it vaginally and stay in the hospital for observation for 6 hours.

Observation after medication

1) Pay attention to the duration and amount of vaginal bleeding after taking mifepristone. If the amount of bleeding is heavy or there is tissue discharge, you should go to the hospital for treatment in time;

2) After using prostaglandins, the patient needs to stay in the hospital for observation to check blood pressure, pulse, diarrhea, abdominal pain, bleeding, whether the fetal sac is expelled, and any side effects of the medication. If some side effects are more obvious, timely symptomatic treatment can be given. And record it in detail;

3) After the fetal sac is expelled, a medical staff will carefully check the expelled material (the uterus will be cleaned at any time if there is a lot of bleeding), and the patient will be discharged after 1 hour of observation. Before leaving the hospital, the blood pressure and pulse will be measured, recorded, and the follow-up date and precautions will be given (2 weeks and 6 weeks after abortion);

4) Patients whose fetal sac has not been expelled will be discharged from the hospital within 6 hours and will be scheduled for ultrasound examination and follow-up within 1 week. If the abortion fails, artificial abortion vacuum aspiration will be performed;

5) On the 15th day of medication: All subjects were required to return for a follow-up visit 2 weeks after taking the medication. If the bleeding is more than the menstrual volume, you should go to the original hospital for examination. For patients diagnosed with incomplete abortion through B-ultrasound and HCG examination, uterine curettage should be performed as appropriate and the patient should be sent for pathological examination.