Abortion methods for 3-6 months of pregnancy

The methods of abortion for pregnancy 3-6 are:

(I) Curettage

In the United States, dilatation and evacuation (D&-E) is the most commonly used method for artificial abortion in pregnancy from 3 to 6 months. The classic D&E method is to use an absorbent seaweed dilator to dilate the cervix and then perform curettage the next day. It is very helpful to add ultrasound guidance during the operation. The improved method is to leave the seaweed band in the cervical canal for 2 days or longer to fully dilate the cervix. In the early stage of pregnancy from 3 to 6 months, taking misoprostol 600r orally 2 to 4 hours before the operation can dilate the cervix to 14mm, which is very beneficial for the subsequent curettage operation. This method is gradually replacing the seaweed band dilation method. In the late stage of pregnancy from 3 to 6 months, the method of seaweed band dilation plus intrauterine injection of digoxin and induction of uterine contractions is used.

(ii) Induction of labor by intra-amniotic injection of ethacridine

Ethacridine is a powerful bactericidal agent that can cause contraction of uterine muscles in vitro and in vivo. Injecting 10 ml of 0.5%-1% ethacridine into the amniotic cavity can cause uterine contraction and promote the expulsion of the fetus and placenta. The clinical efficacy of inducing labor is 90%-99%.

(III) Water bag induction

Use a double-layer condom (empty the air between the two layers) and put it on the front end of the 14-18 urinary catheter, tie it with thick silk thread once at 5cm and 8cm from the end, exhaust all the air, and sterilize it under high pressure for later use. The difference between the low-position small water bag and the low-position small water bag is that the thick silk thread is tied once at 5cm from the end of the urinary catheter.

4. Methods of inducing uterine contractions

1. Prostaglandins (PG)

(1) Overview: PG is a group of 20-carbon unsaturated fatty acids containing a five-carbon ring that are widely distributed in various tissues of animals and have multiple physiological functions. PG can promote or inhibit the activity of adenylate cyclase or phosphodiesterase, and the series of products of PGE and PGF can cause uterine contractions at all stages of pregnancy.

(2) Administration of PG: intra-amniotic injection, intramuscular injection, oral, vaginal or rectal administration.

(3) Classification

1) Carboprost and dinoprost are 15-methyl analogs of PGF2a and PGE2, which can effectively induce uterine contractions but produce side effects of vomiting and diarrhea.

2) Misoprostol is a 15-methyl analogue of PGEi. For patients with 12-22 weeks of pregnancy, the induction effect of 200 p-g of misoprostol vaginally administered every 12 hours is equivalent to the effect of 20 mg of dinoprostatic suppositories administered every 3 hours, regardless of whether the fetus is alive or dead.