Steps in the 9-week inestaking drug abortion process

The article was consulted professionally by Bsck II Pham Thi Tuyet Mai – Obstetrics and Gynecology Department – Share99 Hai Phong International Health Hub.

Medical abortion is also known as oral abortion due to its effectiveness, safety, low cost, so this method is increasingly widely selected, this is a method of bringing the drug into the body to cause natural abortion.

Viet Nam has one of the highest abortion rates in the world, with an estimated 500,000 abortions in the country every year. There are two forms of abortion used today: general abortion and medical abortion. In which, a non-physical abortion is a form of insertion of instruments into the uterus to remove the pregnancy, also known as an internal abortion,also known as oral abortion , which is a method of bringing the drug into the body to cause natural abortion.

Medical abortion due to its effectiveness, safety and convenience is increasingly widely selected. The two drugs used in this method are mifepriston and misoprostol. In it, Mifepriston is a substance with anti-progesterone effect, which makes the lining of the uterus not develop favorable for the nesting of fertilized eggs. Misoprostol is a conductive of prostaglandins, which has the effect of spasms of the uterus to send the pregnancy out.

Medical abortions should be performed in medical facilities by obstetrician and gynecologist doctors trained in medical abortion and proficient in surgical abortion techniques. Although it is a safe method, there are few accidents, but it is very dangerous if pregnant women buy their own medicines and do it at home.

A medical abortion through the end of 9 weeks of amnica is a method of causing miscarriage using a combination of Mifepriston and Misoprostol for pregnancy until the end of 9 weeks (63 days). This method is in dinhed with pregnancy in the uterus of gestational age consistent with the applied gland. Specifically:

• Central health facilities: Applicable for gestational age up to the end of 63 days
• Provincial health facilities: Applicable for gestational age up to the end of 56 days
• District health facilities: Applicable for gestational age up to the end of 49 days

Before implementation, women wishing to have an abortion will be examined by a doctor for clinical examination, an ultrasound of the pregnancy to accurately assess the gestational age, the doctor will exploit the medical history of the pregnant woman, the history of allergies. Oral abortions are absolutely contrained in pregnant women who are allergic to mifepriston, misoprostol or have health problems such as:

• A renal gland pathology
• Long-term corticoid treatment
• Cardiovascular diseases such as hypertension, embolitisor a history of embolitis, stenosis of the 2-leaf valve.
• Severe anemia, hemulation disorders ,use of anti-freezing drugs

Careful consideration should be given when performing a 9-week internal abortion in breastfeeding women. In women who are placing a uterus instrument, it is possible to obtain the instrument before an abortion with medication. In women with acute genital infections also require treatment before implementation.

3.1. Advising patients on oral abortions

The consultation is usually carried out by a trained female householder as a consultant. Women wishing to have an abortion will be introduced to the procedure of abortion with drugs, the symptoms that appear after taking the drug, the effectiveness of the method. Emphasize the importance of on-time re-examination and affirmation that pregnant women must accept a non-physical abortion (abortion) if a drug abortion fails.

Pregnant women will also be introduced to the side effects of the drug, how to monitor and self-care after taking the drug, emphasizing the symptoms that need to go to medical facilities immediately to be checked with contact information in emergency situations. In addition, pregnant women are also provided with information about the possibility of re-pregnancy after a drug abortion, advice to choose the appropriate method of contraception.

3.2. 9-week abortion procedure with medication

• Pregnancy through 49 days: Pregnant women will be given 200mg of mifepriston at a medical facility, monitored 15 minutes after oral. From 36-48 hours from taking mifepriston, pregnant women drink or suck under the tongue 400 mcg misoprostol. The insing of misoprostol can be taken at a medical facility or at home.
• Pregnancy from 50 to 63 days: Drink 200mg of mifepriston. After 36-48 hours of oral administration of mifepristone, proceed to suck under the tongue 800 mcg of misoprostol, if vomiting a lot can put the last bag. The use of two drugs must be carried out at a medical facility, monitored after taking the drug for at least 3 hours.

3.3. Monitor patients after an abortion with oral medications

After taking the medicine, the pregnant woman will be monitored for signs of survival once an hour in the first 3 hours. Monitor abdominal pain, vaginal bleeding, and possible side effects such as vomiting, nausea, fever, diarrhea. Give the pregnant woman painkillers if necessary.

After 2 weeks of drug abortion, the pregnant woman will re-examine the doctor to evaluate the results of treatment. If the miscarriage is complete, the treatment is considered to be over. If an ultrasound is performed, the placenta isdetected, the pregnancy isleft over, the doctor will give the pregnant woman 400-600 mcg of misoprostol orally/sucked under the tongue or sucked the uterus chamber. If the pregnancy continues to develop, it is necessary to use the method of suction of the pregnancy. If there is a phenomenon of blood retention in the uterus chamber, depending on the degree, medical treatment or suction of the uterus can be carried out.

• Multiple bleeding: Multiple bleeding is determined when vaginal blood is soaked 2 by thick sanitation for 1 hour and lasts 2 hours in a row. When a lot of bleeding does not affect the total condition, if the miscarriage is progressing and the cervical sac, using nippers to remove each other's tissue, for patients with uterus contractions such as oxytocin, misoprostol,… If bleeding affects the total condition, both perform the above procedures and resenter the patient.
• Prolonged bleeding, signs of anemia:medical or medical treatment depending on the condition.
• Bacterial infections: Patients with symptoms such as fever, chills, abdominal or pelvic pain, foul-smelling intestant uterus, prolonged vaginal bleeding, increased leukocytity, increased CRP. Patients will receive high-dose antibiotics, medical or medical treatment depending on the condition.

Dr. Tuyet Mai has more than 30 years of experience in examination and treatment in the field of Obstetrics and Gynecology, especially in lower-sugar surgeries, family planning, specialized laparoscopic surgery, handling many serious and difficult surgeries such as:

• Hymenectar surgery, hymen patching
• Uterine fibroid surgery, cervical cancer
• Cervical cancer vaccination
• Early detection of cervical cancer
• Cervical in combustion
• End noisy examination and treatment

Any questions that need to be answered by a specialist as well as customers wishing to see and treat at Share99 International Health Hub, you can contact Share99 Health System nationwide or register online HERE.

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