Surgical abortion

Surgical abortion is called the set of surgical techniques that have the purpose of provoking induced abortion or voluntary termination of pregnancy . 1

The IVG can also be performed until the first 8 or 9 weeks abortion drug or chemical (using drugs such as mifepristone and misoprostol ). 1

Surgical methods

Abortion by aspiration

Manual aspiration is a very safe way to have an abortion. It is a very simple surgery that lasts about 15 minutes. Local anesthesia is usually used; Only in exceptional cases is general anesthesia required. This method can be performed from the first three weeks of pregnancy until the 12th. The procedure is to dilate the cervix to introduce a flexible cannula and aspirate the fetus with a syringe. The thickness of the cannula and dilatation will depend on how advanced the pregnancy is.

It is important to have the personnel trained to perform the aspiration. The woman stays at least two hours in the office because she has to wait until the effect of the anesthesia has passed and to see that colic does not increase.

Abortion by dilation and scraping: curettage

The method of dilation and curettage (see D & C ) is a general method that is also used during the medical examination to take samples or for the detection of certain cancers and is usually done between the sixth and fourteenth weeks. The World Health Organization (WHO) recommends that this method is not used except when manual aspiration is not feasible, and in fact its use is infrequent. The curettage is used to clean the walls of the uterus with a curette . 2

Induction of premature labor

In advanced stages of gestation , if an abortion is to be performed for therapeutic reasons, other appropriate procedures are used for the fetal developmental stage. It can induce premature labor using prostaglandins , while injected serum saline or urea in the amniotic fluid , which causes fatal burns in the fetus.

Dilation and evacuation

The method of dilation and evacuation (D and E) can be practiced from the fifteenth week until the twenty-sixth week of pregnancy. It basically consists of the opening of the cervix , emptying it through the use of surgical instruments and suction.

Partial birth abortion

In the more advanced cases, exceptional techniques are used, such as the call for dilatation and intact extraction or ” partial birth abortion “, which requires two or three days of preparation to ensure the necessary cervical dilation and the drugs that induce labor. The doctor will manipulate the fetus, to make its legs leave first, until leaving only the head, if necessary. Finally, the brain is emptied by suctioning after making an incision at the base of the skull. This technique, which is controversial, applies in less than one-sixth of the late abortions practiced in the United States ; ie when the prenatal development has passed the stage of embryo and is called fetus -see human embryo implantation , human embryogenesis – and was banned by the administration of George W. Bush , but was supported by Tony Blair in the UK .

Choice of method by gestation time

The choice of one technique or another depends on how advanced the pregnancy is and whether cervical dilatation is necessary or not.

From the 15th week to the 26th week of pregnancy , the dilation and evacuation method (D & E), which consists of the opening of the cervix , is emptied using surgical instruments and suction.

It is necessary to use other techniques to induce abortion from the third trimester. The premature birth can be caused by prostaglandin , which can be applied with an injection of amniotic fluid with caustic solutions (saline) or urea .

After the 16th week of gestation, abortion may be triggered by intra-uterine cranial compression, which requires decompression of the fetal head before its evacuation. Abortion by hysterotomy is a procedure similar to cesarean section , and is performed under general anesthesia , because it is considered a major abdominal surgery. 3

When the fetus is at an advanced gestational age of six to nine months, some countries apply the method of partial-birth abortion , a procedure that has led to several legal disputes. 4

Of the 20 to 23 weeks of pregnancy , an injection is needed to stop the heart of the fetus. 5 Of course, late techniques put the mother’s health at much greater risk.

References

  1. ↑ Jump to:a b Comparison of Surgical Abortion and Abortion by Pill, .fwhc.org
  2. Back to top↑ World Health Organization. (2003). Managing complications in pregnancy and childbirth: a guide for midwives and doctors . Accessed August 19, 2006. (in English)
  3. Back to top↑ Abortion . (2007). MSN Encarta. Accessed July 1, 2007. (in English)
  4. Back to top↑ BBC Brazil (2003). Critics entram na Justiça against US proibição of abortion us . Consulted the 22 of February of 2008. (in Portuguese)
  5. Back to top↑ Vause S, Sands J, Johnston TA, Russell S, Rimmer S. (2002). PMID 12521492 Could some fetocides be avoided by more prompt referral after diagnosis of fetal abnormality? J Obstet Gynaecol . 2002 May: 22 (3): 243-5. Consulted on March 17, 2006. (in English)