Medical Termination of Pregnancy
Overview of Medical Termination of Pregnancy
This is the procedure through which pregnancy is terminated by using medicines – rather than by having an operation. There are three different methods of medical abortion. The first method uses a drug called misoprostol alone. The second method uses methotrexate followed by misoprostol; while the third method uses mifepristone followed by misoprostol.
The one most commonly used method is the combination of mifepristone and misoprostol. This procedure can be conducted up to 63 days or nine weeks after the start of the last period.
Treatment procedure for Medical Termination of Pregnancy
Day 1 (First stage): Oral consumption of mifepristone 600 mg at the hospital.
Day 3 (Second stage): Vaginal prostaglandin tablets are given in the hospital 2 days later. Misoprostol, a prostaglandin (PG) analogue can also be administered after mifepristone. Rh negative women are given Rh (D) immune globulin any time before the administration of misoprostol.
Follow-up treatment: A swab test for Chlamydia.
A final check-up 1-2 weeks later.
How does the Termination of Pregnancy works
During the first stage of the treatment, the mifepristone works by blocking the action of the hormone which makes the lining of the uterus (womb) hold onto the fertilized egg.
During the second stage, the prostaglandin tablets work by relaxing the cervix (neck of the womb) and making the uterus contract so that the pregnancy is expelled. Thereby resulting in a miscarriage. Misoprostol, the analogue of prostaglandin (PG) increases the efficacy of treatment by inducing uterine contractions.
Medical Termination of Pregnancy is not for
- People with ectopic pregnancy (where the egg is implanted in the fallopian tubes rather than in the womb) or undiagnosed adnexal mass.
- People fitted with contraceptive coil (IUD or IUS). The coils should be removed before the procedure is undertaken.
- People allergic to mifepristone, misoprostol, or other prostaglandins.
- People on concurrent long-term corticosteroid therapy.
- People with chronic adrenal failure.
- People suffering from hemorrhagic disorders or on concurrent anticoagulant therapy.
- People with inherited porphyrias.
Moreover, patients with the following health issues should consult the physician before under going this treatment:
- People suffering from heart problems or high blood pressure.
- People suffering from asthma, bronchitis or diabetes.
- People with high blood cholesterol level.
Additionally, lactating mothers should stop breast feeding for 14 days after the treatment. She should express and discard the breast milk during these 14 days. She can restart breast feeding only after consulting her physician.
Side Effects for medical termination of pregnancy
Pain and Cramping, Bleeding, Gastrointestinal Side Effects, Thermoregulatory Changes, Headache and Dizziness
Risk Factors for medical termination of pregnancy
Medical termination of pregnancy carries a small chance of complication. The common risk factors are: Persistent bleeding, Treatment failure, Pelvic inflammatory disease (PID), Emotional/psychological problems
Vacuum Aspiration
In most cases vacuum aspiration is necessary as a backup for medical abortion. The vacuum aspiration is provided in an office setting using either electric or manual suction.
Follow-up After Medical Abortion
Follow-up of all medical abortion patients is critical to determine if the abortion is complete. Moreover, such treatments also detects the occurrence of any complications. The schedule for the followup treatment depends on the employed medical abortion protocol. Usually, it is scheduled within 2 weeks of administration of mifepristone or methotrexate.
Medical Abortion and future pregnancy
The risk of ectopic pregnancy, miscarriage, preterm birth or low birth weight babies in future pregnancies after medical abortion is the same as that in surgical abortions. Research conducted on a group of 12,000 women showed that rates of ectopic pregnancy in subsequent pregnancies were 2.4% for medical abortion and 2.3% for surgical abortion. Similarly, rate of miscarriage was 12.2% for medical abortion and 12.7% for surgical abortion.
Written by: Healthplus24 team
Date last updated: March 24, 2012