Abortion Procedure

Abortion literally means to scrape, and as used in gynecology and obstetrics, it means to remove tissue from the uterus. It is not performed only to terminate pregnancy.

Abortion can be performed for diagnostic purposes (probe abortion), especially in bleeding disorders and post-menopausal bleeding. Abortion can also be performed to determine whether ovulation occurs during infertility investigations.

Abortion for the purpose of terminating pregnancy is legally performed in our country until the 10th week of pregnancy. If the baby is dead, if the baby has a serious abnormality (disability) that is incompatible with life, or if the pregnancy is medically unsafe, abortion can be performed in later weeks of pregnancy. Abortion Practice: Legal abortions can be performed under both local anesthesia and general anesthesia. Although abortion under general anesthesia increases the cost slightly, it is preferred and recommended both for the mother's psychology and for the procedure to be completely painless. After the patient sleeps, the patient is positioned and first a gynecological examination is performed to evaluate the condition and size of the uterus.

After the characteristics of the uterus are understood, a vaginal speculum is placed. The cervix becomes visible with the speculum. Precautions are taken against a possible infection by washing the vagina and cervix with antiseptic solutions. If local anesthesia is to be applied, it is done at this stage and medication is injected into both sides of the cervix. Then, the cervix is ​​held with an instrument called a single tooth. This procedure may be painful. The single tooth is removed and the uterus becomes flat. With the help of tools called bougies, the cervix begins to be widened (dilatation). For this purpose, the thinnest possible spark plug is used. The plugs are numbered according to their diameter in millimeters (1, 2, 3, 4, 5.....). After the dilation process is completed, plastic (carmen) cannulas are passed through the cervix and the uterine cavity is reached. After the cannula is inserted, its tip is connected to a special syringe that creates vacuum for this purpose. By opening the button of the syringe, negative pressure is created and the inside of the uterus is cleaned by moving the syringe back and forth. The procedure continues until the inside of the uterus is completely cleaned.

 

If it is decided to terminate a pregnancy longer than 10 weeks due to a medical reason and by the decision of the board of physicians, this process is done by connecting larger cannulas to vacuum devices and then it is checked whether there are any pieces left with sharp curettes. .

 

The most common problems in applications performed with local anesthesia (numbing) are allergy to the local anesthetic substance, hypersensitivity and vasovagal syncope (fainting). This is usually a temporary situation and does not cause any problems. Pain, nausea and vomiting are also common problems after the procedure. Sometimes the cervix may be hard enough to not allow the cannula to pass and the procedure may be interrupted. In this case, the procedure is repeated after 1 week. In small pregnancies (<4 - 4.5 weeks), the abortion procedure may fail.

 

Evacuation is postponed until one week later. Bleeding after abortion can last up to 1 week, but if bleeding lasts longer, it should be checked, there may be a piece left inside. Rarely, the uterus may be pierced depending on the menstrual period used. This may cause internal bleeding, damage to the intestines, and sometimes the puncture site may close with mild pain and contraction of the uterus without any symptoms... Infection usually occurs in abortions that are not performed under sterile conditions or in pregnancies that die in the womb. Infection and inflammation manifest themselves as pain, discharge, and excessive bleeding.

 

This problem is rarely observed if the antibiotics given after abortion are used regularly. The most important but rare problem seen in the late period is adhesions (Asherman syndrome) that occur as a result of excessive damage to the inner layer of the uterus during the procedure. It manifests itself as the absence of menstrual bleeding 4-5 weeks after the abortion and the inability to cause bleeding with medication. It is rarely observed in evacuations carried out within legal limits and especially in vacuum procedures. Abortion is a sensitive issue that brings legal responsibilities and requires maximum attention. The legal limit for optional abortion is up to 10 weeks, but if the baby has a disability etc. If this is the case or if the baby's heartbeat is not observed, the pregnancy can be terminated until the 24th week, which is the life limit.

 

Those who have not completed the age of 18 can have an abortion with the written and signed permission of their parents. If the patient is married, the father's consent and permission is required, but if the patient is not married and has completed the age of 18, she can terminate the pregnancy at her own request. Every patient can have an abortion before the procedure. Information about the procedure should be given and the complications of the procedure and the problems it may cause should be explained.

 

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