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Abortion Tips

Ectopic Pregnancy - How to Treat It?

Ectopic Pregnancy - How to Treat It?

An ectopic pregnancy takes place in the case when the completely fertilized egg attaches itself to a place outside the inner side of the uterus. Ectopic pregnancy is also called tubal pregnancy because in most cases, it takes place in the Fallopian tube. Usually, the Fallopian tubes are not responsible for holding an embryo, which keeps on growing. Hence, the egg has no scope to develop in the Fallopian tube. This problem must be treated as soon as possible to avoid further complications. Here are several ways of treating ectopic pregnancy.

  1. Expectant management: In case you are not experiencing any symptoms of pregnancy or the pregnancy cannot be found, close observation is required. This is known as expectant management. You should conduct regular blood tests and follow them up in order to detect, whether the hCG level in your blood is ascending or descending. You are likely to have vaginal bleeding. Use pads and towels instead of tampons. Pain in your tummy is also indicated.
  2. Proper medication: In case ectopic pregnancy is detected at an early stage and constant monitoring is not suitable for you, a medicine by the name of methotrexate can be used for treatment. The medicine stops this pregnancy from developing. It is usually injected into your buttocks. Regular blood tests must be carried out to know how the treatment is taking shape on your condition. Trusted contraception measures should be taken for three months following the treatment as methotrexate is very harmful for an infant in case you become pregnant. Keep away from alcohol, as the combination of methotrexate with alcohol is harmful to the liver.
  3. Surgical means: The most common mode of surgery for removing ectopic pregnancy during an early stage is laparoscopy or keyhole surgery. While a laparoscopy is carried out, you will be in a state of anesthesia. A narrow tube or the laparoscope is inserted through surgical cuts in the tummy. The Fallopian tube, which had the ectopic pregnancy is totally removed in case the other Fallopian tube is functioning well. Else the pregnancy has to be somehow removed without cutting off the Fallopian tube. Removal of the Fallopian tube is the best remedy for treating ectopic pregnancy and getting pregnant again is also possible. It takes a normal woman almost six weeks to recover after the surgery. Laparotomy is another kind of surgery carried out to repair a ruptured Fallopian tube.
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Abortion Habitual

Abortion is the expulsion of products of conception either fully or partially.
The causes of abortion vary from hormonal disturbances any trauma or injury, a severe shock, infectious and foetal abnormalities. It is a nature's way of rejecting a malformed baby.
Other reasons can be:
TORCH infections.
Uterine weakness or displacement.
Cervical canal weakness.

SYMPTOMS:

Bleeding from vagina either profuse or in spots.
Pain is usually the dull type of pain in abdomen and back.


DO'S and DONT'S:

If you have a bad obstetric history like repeated abortions, malformed foetuses, consult a gynaecologist as soon as pregnancy is suspected.
Do not over strain, carry weights, or do laborious jobs during pregnancy.
Take plenty of rest but do take some light exercise. Exercises should be done only under the medical guidance or expert opinion.
Take doctor's advice on diet and medicate.
Do not self-medicate.

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Choice between Surgical and Medical Abortion

There are two methods by which abortion can be done

Medical Abortion -non-surgical abortion in which medicines are used to induce abortion
Surgical Abortion - Use of transcervical procedures for terminating pregnancy, including vacuum aspiration, and dilatation and evacuation (D&E).

Surgical or Medical Abortion for Unwanted Pregnancy

If pregnancy is <= 7 weeks; medical Method with Mifepristone with misoprostol is favorable as success rate is as high as 97%.
If pregnancy is between 7-12 weeks; surgical abortion is the only option.
If pregnancy is beyond 12 weeks – 20 weeks, then woman needs to be hopsitalized and will be given either Mifepristone followed by Misoprostol tablet or only misoprostol tablets and woman will then abort like a miscarriage in the Hospital. If any products are remaining then it will be evacuated surgically.
Surgical abortion is preferred if patient desires concurrent tubal ligation or IUCD (CuT) insertion.
If a woman fulfills the criteria for selecting either method i.e. Before 7 weeks), final choice to be given to the woman.

Summary of Choice between Surgical or Medical abortion in India

<= 7 weeks – Medical method or Surgical method
7-12 weeks – Surgical abortion
12 – 20 weeks – Medicines with or without surgical procedure in Hospital.

Advantages of Medical Abortion

Avoids surgery. Controlled by the woman and may take place at home. No need for admission to the Hospital. Usually well tolerated by women if properly counselled and motivated. No need to take leave from work, as bleeding can be manged with menstrual pads even while in office or at work.

Disadvantages of Medical abortion

Takes time (hours to days) to complete abortion, and the timing may not be predictable. Women experience bleeding and cramping, and potentially some other side-effects (nausea, vomiting, fever, and shivering). May require more clinic visits than surgical abortion.

Advantages of Surgical Abortion

Quick procedure. Complete abortion easily verified by evaluation of aspirated products of conception. Takes place in a Hospital so Sterilization or placement of an intrauterine device (IUD) may be performed at the same time as the procedure. It can be performed under local anaesthesia if woman is properly motivated and counselled.

Disadvantages of Surgical abortion

Requires instrumentation of the uterus. Small risk of uterine or cervical injury. Timing of abortion controlled by the Doctor and Hospital. Anaesthesia wneeds to be administered. Most doctors perform this procedure under short general anaesthesia. Woman needs to be in the Hospital for at least 6 hours. Effect of sedation will be there throuout the day.
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Medical Abortion With Tablets - Myths and Facts

Medical abortion using tablets is the need of the hour especially for today's youngsters. Improper and inadequate knowledge about safe sex practices and contraception can create a lot of problems for the young couples.
My sincere appeal to all young couples is not to feel shy and hesitant in approaching a doctor for advice on contraception as because nobody is going to be judgemental on them. It is a professional world and any doctor would be more than eager to help out a patient.
Generally what happens is whenever there is a pregnancy happening out of a relationship, it puts the couple in a panic situation and there is a tendency to try and get over the counter medicines or maybe approach quacks or try and consume some so called food items which may lead to an abortion. These are the usual mistakes done by youngsters as they want to hastily get out of the mess without having to tell anybody.
The biggest concern in approaching a known doctor is the couple does not want to get identified, secondly they feel the doctor is going to take them through a long drawn medical procedure which is going to be costly and they would probably be asked to come along with a parent or a guardian for obvious reasons and hence they refrain from meeting a doctor.
Now coming to the facts-----
1. No need to panic if you realise that you have an unwanted pregnancy
2. Approach a gynecologist as soon as possible
3. If the doctor asks you get a sonography done please do so
4. You should always be knowing your blood group and hemoglobin levels before taking any tablets for abortion
5. Abortion can be very safely done with tablets under the guidance of a gynecologist and you do not need any hospitalisation. 2--3 visits to the clinic can complete the procedure
6. Only 1-2% patients may require a curettage of the uterus if the procedure does not get completed with tablets, which definitely the treating doctor would discuss with the couple and explain.
7. This medical abortion with tablets is not overtly expensive and is quite manageable with your pocket money (mobile phones are much more expensive).
8. There are no long term side effects of this procedure on your future fertility
9. Most of the doctors would be cooperative and would protect your privacy. You may have to sign a few forms for you should not hesitate as it is part of the procedure.
10. Nobody is going to be judgemental on you so take it easy and seek medical advice.
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