What are the dangers of multiple abortions for women? The most comprehensive care knowledge for women after abortion

Multiple abortions can cause great harm to women's uterus. The reason why many women suffer from infertility is that they have had too many abortions before, which makes their endometrium thinner and thinner, so they can no longer get pregnant. Even after getting pregnant, there is a risk of habitual miscarriage, which means they cannot get pregnant successfully. Therefore, do not have abortions frequently.

Indications

1) Healthy women diagnosed with normal intrauterine pregnancy (last menstrual amenorrhea ≤ 49 days) who voluntarily request to terminate pregnancy with drugs, aged 18-40 years; 2) High-risk abortion targets, such as those with reproductive organ malformations (except rudimentary uterine horns), severe pelvic deformities, extremely tilted uterus, cervical dysplasia or tough uterus, scarred uterus, multiple artificial abortions, etc. (Note: Even if these patients choose medical abortion, they still have high-risk factors for medical abortion, and the failure rate of medical abortion and the chance of post-abortion bleeding are higher than those without high-risk factors); 3) Those who have concerns or fears about surgical abortion.

Contraindications

1) Contraindications of mifepristone: endocrine diseases such as adrenal glands, diabetes, thyroid gland, abnormal liver and kidney function, history of skin itching during pregnancy, history of blood diseases and vascular thrombosis, tumors related to steroid hormones

2) Contraindications of prostaglandins: cardiovascular diseases, such as mitral stenosis, hypertension, hypotension, glaucoma, gastrointestinal disorders, asthma, epilepsy, etc., or those who are allergic to prostaglandins;

3) Those with allergic constitution or severe vomiting during pregnancy;

4) Anemia, hemoglobin level is 100g/L or below;

5) Pregnant women with an IUD;

6) Ectopic pregnancy or hydatidiform mole;

7) Smokers who smoke more than 10 cigarettes a day or drink alcohol;

8) Those who often travel on business, come to Beijing from other places, live far away from medical institutions, and cannot receive timely medical treatment and follow-up;

9) Inflammation of the reproductive tract, such as vaginitis, acute suppurative cervicitis or subacute cervicitis, acute and chronic pelvic inflammatory disease, sexually transmitted diseases, etc., which have not been treated.

Pre-medication treatment

1) The doctor should explain the medication method, efficacy and possible side effects to the recipient, and the recipient can make a voluntary choice; 2) Physical examination and testing are the same as vacuum aspiration; 3) The pros and cons of medical abortion should be explained to pregnant women, and they can make a natural choice.

Directions

Mifepristone: Generally, the first dose is given in the outpatient clinic, and the rest can be taken home by the patient; Prostaglandin: Patients are required to come to the hospital for medication and stay in the hospital for observation, take it on an empty stomach on the morning of the third day, or insert it vaginally and stay in the hospital for observation for 6 hours.

Observation after medication

1) After taking mifepristone, pay attention to the duration and amount of vaginal bleeding. If the amount of bleeding is heavy or there is tissue discharge, you should go to the hospital for treatment in time;

2) After using prostaglandins, the patient must stay in the hospital for observation, including blood pressure, pulse, diarrhea, abdominal pain, bleeding, and whether there is fetal sac expulsion and adverse reactions. If the adverse reactions are more obvious, symptomatic treatment can be given in time. And detailed records should be kept;

3) After the fetal sac is expelled, a medical staff will carefully check the expelled material (the uterus will be cleaned at any time if there is a lot of bleeding), and the patient will be discharged after 1 hour of observation. Before leaving the hospital, the blood pressure and pulse will be measured, recorded, and the follow-up date and precautions will be given (2 weeks and 6 weeks after abortion);

4) Those whose fetal sac has not been expelled should be discharged from the hospital within 6 hours and scheduled for ultrasound examination and follow-up within 1 week. If the abortion fails, artificial abortion vacuum aspiration will be performed;

5) On the 15th day of medication: All subjects are required to return for a follow-up visit 2 weeks after taking the medication. If the bleeding is more than the menstrual volume, the patient should go to the original medication hospital for examination. For those diagnosed with incomplete abortion through B-ultrasound and HCG examination, the uterus should be cleaned and sent for pathological examination as appropriate.