Medical abortion procedures
Medical abortion procedures
are available to terminate pregnancies during the first weeks of the first
trimester.
Ultrasound is recommended for
women seeking medical abortion to determine the viability of the pregnancy
(uterine, ectopic pregnancy) and accurately determine the duration of the
pregnancy.
Types of medical abortion
Methotrexate and Misoprostol
- This is a medical abortion procedure used up to the first 7 weeks (49 days of pregnancy). This procedure is not used as often as it used to be due to the availability of mifepristone.
- Methotrexate is given by mouth or by injection during the first office visit.
- Antibiotics are also prescribed to prevent infection.
- Misoprostol tablets are taken by mouth or inserted into the vagina after about 3-7 days. This can be done at home.
- This procedure usually induces contractions and pushes the fetus out. The process can take from several hours to several days.
- A week later, a medical examination is performed to ensure that the abortion procedure is completed and to check for complications.
- Methotrexate is mainly used to treat cancer and rheumatoid arthritis because it attacks the fastest growing cells in the body. In case of abortion, it causes separation of the fetus and placenta from the uterine lining. The use of the drug for this purpose is not approved.
Side effects and risks of
Methotrexate and Misoprostol include:
- Seizures, nausea, diarrhea, heavy bleeding, fever
- The procedure fails in about 5% of cases, and an additional surgical abortion procedure may be required to complete the abortion.
- Not recommended for women with anemia, bleeding disorders, liver or kidney disease, seizure disorders, acute inflammatory bowel disease or using an intrauterine device.
Mifepristone and Misoprostol
- Mifepristone and misoprostol is a medical abortion procedure used until the first 7-9 weeks of pregnancy. It is also called RU-486 or abortion pill.
- A physical examination is done first to determine if this type of medical abortion procedure is suitable. You are not eligible if you have any of the following: ectopic pregnancy, ovarian neoplasm, use of corticosteroids, adrenal insufficiency, anemia, bleeding disorders or use of anticoagulants, asthma, liver or kidney problems, heart disease, or high blood pressure . You will be given antibiotics to prevent infection.
- Mifepristone is given by mouth during your first office visit. Mifepristone blocks progesterone in the lining of the uterus, causing it to break down and preventing the pregnancy from continuing.
- Misoprostol tablets are taken by mouth or inserted into the vagina about 36 to 72 hours after taking mifepristone. The pills cause contractions and push the fetus out. This process may take several hours or several days.
- A physical examination is done after two weeks to make sure the abortion is completed and to check for complications.
Side effects and risks of
Mifepristone and Misoprostol include the following:
- Seizures, nausea, vomiting, diarrhea, heavy bleeding, infection
- The procedure fails in about 8-10% of cases, and an additional surgical abortion procedure may be required to complete the abortion.
- Not recommended for women with anemia, bleeding disorders, liver or kidney disease, seizure disorders, acute inflammatory bowel disease or using an intrauterine device.