- There are surgical and medical abortions. In 2003, WHO formulated the concept of “Safe Abortion” by updating theserecommendations
in 2012. The first and main rule: abortion should be carried out in a medical institution under the supervision of professionals.
The second rule: for the seventh year already, there is a recommendation to abandon curettage of the uterine cavity with an acute curette. By surgical abortion, WHO experts do not mean “cleaning”, but vacuum aspiration of the contents of the uterine cavity, which does not require aggressive expansion of the cervical canal.
It is the expansion of the cervical canal and the use of sharp metal curettes that creates a high risk of perforation (perforation. - Approx. Ed. ) of the uterus and even damage to other internal organs.
Many developed countries abandoned curettage in the late sixties of the last century.
In our country, for this, there are all the conditions. An alternative to the curette can be simple and inexpensive devices.
In the first trimester of pregnancy, surgical abortion (vacuum aspiration, not curettage!) Is a highly effective method for terminating an unwanted pregnancy. The main possible problems are incomplete evacuation, perforation of the uterus, complications of anesthesia and purulent-septic complications.
Third: the safety of medical abortion is proven, but only with strict adherence to the protocol.
For medical abortion in the early stages, the frequency of complications is small and does not exceed 0.1-5.4%.
According to WHO estimates, 22 million unsafe abortions per year are still carried out in the world, leading to the death of 47,000 women and five million more serious complications. However, 13% of pregnancy-related deaths are due to complications associated with unsafe abortion, corresponding to approximately 67,000 deaths annually.
The drug method of abortion has a slightly lower efficiency; surgical termination of pregnancy is required in 2-8% of cases. It is important to understand that with incomplete evacuation of the fetal egg from the uterine cavity, it is customary to talk not about complications, but about the failure of the method, so there are very few complications from medical abortion.
Check out the 2013 publication of 233,805 medical abortions. Serious adverse events or outcomes were recorded in 1,530 cases (0.65%).
Of these, the majority was prolongation of pregnancy (inefficiency) - 0.5%, and significant adverse effects - 0.16%. Including the death of one patient from an undiagnosed ectopic pregnancy.
The frequency of postabortion uterine inflammation is generally comparable in both interruption methods.
Deadly septic complications are more likely to occur with medical interruptions. The frequency of life-threatening bleeding is also comparable, but if a surgical abortion can be caused by trauma to the cervix or uterus, then with medical abortion, it is atonic bleeding or bleeding associated with the remains of the fetal egg and chorion in the uterine cavity.