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Kadın Hastalıkları ve Doğum Uzmanı - Op. Dr. Nazlı Oral Korkmaz

Abortion

Abortion

Abortion or curettage is the process of obtaining the pregnancy in the uterus by various methods, which is also referred to as abortion, abortion, abortion, or curettage. Abortion is not only done for voluntary pregnancy, it is also done to remove the remaining pregnancy parts after abortion or to take out dead pregnancies and empty pregnancies.

Ectopic pregnancy cannot be taken by abortion, surgery or medication is required. In fact, the procedure is a term used not only for the removal of pregnancy but also for the materials taken from the uterus in non-pregnant patients. It can be abbreviated as D / C or D&C. These letters are short for dilation and curettage.

Dilatation is used to mean widening the cervix. The help of some surgical instruments required to enlarge the cervix to perform curettage into the uterus. Metal spark plugs of increasing thickness are used for this expansion. There are some situations where processing is required. For example;

  • In pregnancies that have not exceeded 10 weeks, the person wants to terminate as a result of his / her own free will and the consent of the spouse.
  • If the baby's heartbeat is not taken even though a certain period of pregnancy has been reached.
  • If a normal pregnancy is at risk for no apparent reason and the baby's heartbeat stops.
  • When there is a gestational sac but there is no baby in it, which is called empty pregnancy.
  • In the process of cleaning the tissues left in the uterus after abortion.
  • In case of continuous irregular bleeding even though the person is not pregnant.

What To Do Before Abortion?

The week of gestation is determined with the help of ultrasound for the abortion procedure. The uterus, in other words, the part of the uterus where it is located is checked. It is learned if there is a difference in the structure and type of the uterus that originates from birth. If there is a myoma originating from the uterine wall, it is understood where it is located in the uterus and its relation to the gestational sac. If the week of gestation is suitable, abortion can be performed on the same day under recommended conditions.

How is an abortion done?

For the curettage procedure, the patient is first placed on the gynecological table and examined. Later, if general anesthesia is to be applied, the vascular access is entered from the arm after the patient is informed about the procedure to be performed by an anesthesiologist or technician. This is an extremely comfortable and painless procedure, just like a needle stick. Then, an anesthetic drug is injected through the vascular access and the patient is put to sleep.

After the patient is put to sleep, the vagina is opened with a device called speculm and the cervix is ​​made visible. After cleansing the vagina with antiseptic solutions, the cervix is ​​pulled out with a tool called teneculm and the uterus gains a flat position.

First, the cervix is ​​enlarged according to the gestational week with flat bars called spark plugs. And finally, it is entered into the uterus with a vacuum injector and aspirated until all signs of pregnancy are removed. This whole process usually takes only 10 minutes and the patient is awakened immediately after the procedure.


What Should Be Done After The Procedure?

After the abortion process is completed, the person can continue her daily routine. However, for the first 12 hours, one should be careful, avoid driving and avoiding work that requires attention. After the operation, pains similar to menstrual contractions are considered normal and it is possible to relieve these pains with the painkiller recommended by the doctor.

Until the next control examination, it is necessary not to do heavy exercise or to have sexual intercourse. In addition, one should not take a shower in the bathtub and swim in the pool. Post-abortion pain and spotting bleeding are considered normal to a certain level, but you should definitely consult a doctor in the following cases.

  • High fever. (38 degrees and above)
  •  Pains that become more severe and more frequent in intervals.
  • Increasing the amount of bleeding and not ceasing.
  • The discharge coming from the vagina with a foul odor and a different color.
  • Cramp-like pains that do not relieve despite pain medication.

 

When Can Abortion Be Done?
Most abortions are done before the 24th gestational week. In very rare conditions, it can be done after 24 weeks. For example, if the mother's life is at risk or the child will be born with a serious disability, it will require an abortion. The duration of pregnancy is calculated from the first day of your last menstrual period. The sooner abortions are done, the safer it will be.

Abortion methods
There are 2 basic types of abortion:

Medical abortion
Surgical abortion


Medical abortion:
It includes the following steps:

You take a tablet first, and it ends the main pregnancy hormone. You take this tablet at the hospital or clinic, then you can go home and continue your normal life.

Medical abortion is taking 2 different medications to terminate the pregnancy.
Medicines are prescribed by the hospital or clinic and are usually taken 1 or 2 days apart.
Pregnancy comes out of the vagina. This usually happens within a few hours after taking the second medication.
It does not require surgery or anesthesia.


Surgical abortion
Surgical abortion involves an operation to get the pregnancy out of the womb. It can be done with:

Local anesthetic
Conscious sedation
Deep sedation or general anesthesia


Most people who undergo deep sedation will remember nothing and will not be aware during surgery. If you have general anesthesia, you will sleep completely during the operation and you will not remember anything. What type of anesthesia or sedation you have depends on your circumstances, how many weeks pregnant you are, and your own preference.

Kadın Hastalıkları ve Doğum Uzmanı - Op. Dr. Nazlı Oral Korkmaz

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