Safe abortion with pregnancy under 12 weeks

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Trinh Thi Thanh Huyen - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital.

1. Learn about current abortion methods

In fact, abortion at 12 weeks (under 12 weeks of age) will be safe and effective when you choose the right method. Usually, the doctor will conduct an examination to determine the fetal age, fetal size and the health of the pregnant woman before giving advice for the safest abortion method to the mother.
There are two main methods that are:
1.1 Medical abortion This is a medical abortion method, using a combination of mifepristone and misoprostol to induce miscarriage. However, when applying this method, it is necessary to have a vacuum abortion service available to promptly handle failed cases. The older the gestational age, the lower the success rate of this method.
1.2 Surgical abortion Using transcervical procedures to terminate a pregnancy, including vacuum aspiration, dilation, and extraction. In which vacuum is the recommended method to choose because of the safety it brings.

2. How is 12 weeks abortion encouraged?

Currently, compared to the 12-week-old abortion method with drugs, the vacuum method is more chosen by many people. Vacuum aspiration is a method of abortion by using a vacuum pump to suck the fetus out of the uterus, applicable to the case of the fetus under 12 weeks of age.
2.1 Indications Apply to fetuses under or equal to 12 weeks of age.
2.2 Contraindications There are no absolute contraindications. Caution should be exercised in cases of acute genital tract inflammation requiring treatment or referral. Note: To ensure a safe abortion at 12 weeks, patients are not allowed to have the procedure at the commune level with the following warning cases:
Less than 6 months after delivery Large uterine fibroids Incision in the uterus Genitourinary tract is malformed The patient has medical and surgical diseases

Performers: Professional and experienced doctors, nurses and midwives trained in vacuum abortion.
Means
Painkillers: Paracetamol 500mg, Ibuprophen 400mg. Anesthetic: Lidocaine 1% (or Xylocaine 1% uterotonics Anti-shock box) The kit to support the vacuum abortion procedure includes: Single-valve aspiration pump, two-valve aspiration pump, MVA plus suction pump, suction tube and lubricating oil Two internal and external antiseptic forceps Cotton swabs and antiseptic solution Valve (or speculum) Syringe, syringe Cervical clamp Candle dilation Post-aspiration tissue testing kit Auxiliary devices help the doctor with equipment and waste disposal Prepare the patient's side
Ask a history of medical and surgical diseases General examination and examination Gynecological examination Take a pregnancy test Ultrasound Visit to determine the gestational age fetus, fetal size Doctor advises: the steps of the method, possible complications, and advice on monitoring health after the procedure Maternity signs a voluntary commitment to abortion The fetus 9 weeks to 12 weeks of age should prepare the cervix by sublingual 400mcg Misoprostol, 3 hours before the procedure Procedure steps
First, patient patients are given painkillers, antibiotics 30 minutes before the procedure
Determine the size and position of the uterus Change into sterile gloves Disinfect the outside, under the patient's buttocks place a clean towel Place the valve, Expose the cervix and disinfect the cervix and vagina Cervical clamp Anesthetize the side of the cervix with medicine Measure the uterine cavity with a suction tube Cervical dilatation (depending on the new case) Aspiration Examination aspirate The doctor evaluates the procedure as completed. If the patient's uterus is guaranteed to be clean, the IUD can be inserted immediately after vacuum aspiration, there are no contraindications and the patient chooses this method. Cervical vaginal disinfection Dispose of equipment and waste as prescribed Monitor and manage complications
Monitor
Monitor pulse, blood pressure and vaginal bleeding for at least 30 minutes after the procedure Prescribe antibiotics 5-7 days Counseling the patient for self-care Post-procedure consultation See back in two weeks

Complications and management
Early complications: Shock, bleeding, uterine perforation, cervical laceration Late complications: infection, stillbirth, placental remnants, uterine adhesions Treat according to the protocol for each event Uterine perforation: if the hole is small, there is no bleeding, make sure the uterine cavity is clean, give antibiotics, uterotonics, monitor the whole situation. If the perforation is larger and there is internal or external bleeding heavily accompanied by damage to the abdominal organs, surgery must be performed to suture the perforation, restore damage to the organs (if any) Cervical tear: Insert gauze wick or suturing the tear Post-aspiration infection Infection: High-dose antibiotic treatment Vaginal bleeding, residual pregnancy: Retraction of the uterus, antibiotic treatment Adhesion of the uterine cavity after suction: dilation of the uterus, artificial menstrual cycle, put a non-stick ring or surgery to separate the adhesion. Abortion 12 weeks (under 12 weeks old) will certainly be safer than abortion beyond 12 weeks, when the fetus in the abdomen is too large, it will cause damage to the uterine region, causing infertility or even is death. Moreover, 12-week abortion will be safer if carried out with safe therapies, by highly qualified doctors at large and reputable hospitals.
In fact, when having an abortion, pregnant women will feel less pain. If anesthesia is not given, the pain is relatively strong, potentially causing the abortion participant to feel weak, lose blood and faint. But if you are anesthetized, taking antibiotics will make the pain much milder, so pregnant women are completely assured.
Master. Trinh Thi Thanh Huyen is highly trained in obstetric ultrasound, laparoscopic surgery and hysteroscopy at the National Hospital of Obstetrics and Gynecology and has more than 13 years of experience working at Hai Phong Obstetrics and Gynecology Hospital.
Currently the doctor is an Obstetrician and Gynecologist at Vinmec Hai Phong International General Hospital
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