ABORTION OR MEDICAL ABORTION IN EARLY PREGNANCY LOSSES?

Approximately 10-15% of all pregnancies result in miscarriage, and more than 90% of these occur during early pregnancy. In early period (<12 weeks) pregnancy loss, D/C procedure, popularly known as “Abortion”, is applied classically to remove the pregnancy material from the uterus. This procedure is performed under anesthesia and the pregnancy material in the uterus is evacuated using special medical tools. Alternatively, the uterine contraction process can be initiated by drug administration and self-cleaning can be achieved by pushing the pregnancy outward (medical abortion). For this purpose, the drug with the active ingredient “Misoprostol” is administered vaginally or orally under the control of a doctor. The reason why this method is preferred in suitable cases is the desire of the patient to be protected from infection, uterine perforation, adhesion formation in the uterus and the risks of anesthesia.However, it should not be forgotten that after this procedure, if the uterus is not fully emptied and tissue remains inside, surgical curettage (D/C) can be applied to the patient again. The rate of patients who underwent an extra curettage procedure varies between 15-22% in various studies. Unfortunately, it is an insignificant rate. In patients who underwent surgical curettage (D/C), the probability of repeat curettage is 3%, and the rate of intrauterine adhesions reaches 20%. In recent studies, the possibility of getting pregnant in the first year after the procedure was investigated in patients who underwent surgical curettage (D/C) and patients who underwent medical abortion (abortion using medication), and the groups showed similarity to each other.

In summary;

  1. It iIt is more reliable in terms of problems caused by medical abortion, surgical curettage (D/C) procedure, intrauterine adhesions, infection, uterine perforation and anesthesia.
  2. In 20% of medical abortion cases, extra surgical curettage (D/C) may be required because the uterus is not fully emptied.
  3. Medical abortion can take a long time. There may be miscarriages lasting between 1 week and 1 month. This can turn into a psychological trauma for patients.
  4. Abortion drugs used in the medical abortion process can cause frequent and severe groin pain.
  5. It is not clear when the medical abortion process will begin. It can be at night, or it can be at any time during the day.
  6. Both methods are reliable in terms of future pregnancy planning.

In the decision-making process, attention should be paid to the psychological state of the person, uterine anatomy, socio-cultural level and health status.

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