Abortion literally means scraping, as it is used in obstetrics and childbirth, it means taking tissue from the uterus. It’s not just for terminating a pregnancy.
Diagnostic abortion can be performed especially in bleeding disorders and post-menopausal bleeding (probe abortion). Again, in infertility researches, abortion can be applied to understand whether there is ovulation or not.
Abortion for the purpose of termination of pregnancy is legally practiced until the 10th week of pregnancy in our country. If the baby is dead, if the baby has a serious abnormality (disability) incompatible with life, or if the pregnancy is medically inconvenient, abortion can be performed at later weeks of gestation. Abortion Application: Legal evacuations can be performed under both local anesthesia and general anesthesia. Although abortion under general anesthesia increases the cost a little, it is more preferred and recommended in terms of both the psychology of the mother and the completely painless course of the procedure. After the patient is asleep, the position is placed and a gynecological examination is performed first to assess the condition and size of the uterus.
After understanding the characteristics of the uterus, a vaginal speculum is inserted. With the speculum, the cervix becomes visible. 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 the drug is injected on both sides of the cervix. Then, the cervix, the cervix, is held with an instrument called a monotooth. This procedure can be painful. By pulling a single tooth, the uterus becomes flat. With the help of instruments called bougies, the cervix begins to expand (dilatation). For this, the thinnest possible spark plug is used. Bougies 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 to reach the uterine cavity. After the cannula is placed, its tip is connected to a special injector that creates a vacuum produced for this purpose. Negative pressure is created by opening the button of the injector, and the inside of the uterus is cleaned by moving the injector back and forth. The process is continued until the inside of the uterus is completely cleaned.
If it is decided to terminate a pregnancy greater than 10 weeks due to a medical reason and with the decision of the physicians board, this procedure is done by connecting larger cannulas to the vacuum devices, and then it is checked whether there are any pieces with sharp curettes.
The most common problems in the applications performed with local anesthesia (numbing) are allergy to local anesthetic substance, hypersensitivity and vasovagal syncope (fainting). This is usually a temporary situation and does not pose a problem. Pain, nausea and vomiting are also common problems after the procedure. Sometimes, the cervix may be so rigid that it does not allow the cannula to pass, and the procedure may be interrupted. In this case, the process is repeated after 1 week. Abortion may fail in small pregnancies (<4 – 4.5 weeks).
The evacuation is postponed to a week later. Bleeding after abortion may last up to 1 week, but in cases of longer bleeding, control should be performed, there may be pieces left inside. Rarely, the uterus may be perforated depending on the menstrual periods used. This can cause internal bleeding, damage to the intestines, and sometimes without any symptoms, the punctured place can be closed with the contraction of the uterus with mild pain. Infection, inflammation manifests itself in the form of pain, discharge, excessive bleeding.
In the case of regular use of antibiotics given after abortion, this problem is also rarely observed. The most important but rare problem seen in the late period is adhesions (Asherman’s 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 even after 4-5 weeks from the abortion and the inability to create bleeding with drug treatment. It is rarely observed in the evacuations carried out within the legal limits and especially in vacuum applied processes. 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 is disabled, etc., or if the baby’s heartbeat is not observed, the pregnancy can be terminated up to 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 consent of their parents. If the patient is married, the consent and consent of the father is required, but if the patient is not married and has completed the age of 18, they can terminate the pregnancy voluntarily.