Abortion

Abortion or, MTP
MTP stands for Medical Termination of Pregnancy)

Methods used:

Surgical Method (surgical evacuation)
Medical Method (using drugs)

Which method to use depends on length of pregnancy and related complications.

Surgical evacuation of the uterus is the most commonly employed method of abortion (more than 90% of cases).

For 7 – 12 weeks: It is called suction and curettage. A flexible tube is inserted into the uterus by forced opening of the cervix. Using suction pumps and forceps the fetus and the placenta are removed. Mild scraping of the wall of the uterus is the last step.
However, for pregnancies of more than 18 weeks, dilation and evacuation can cause serious complications.

Medical Method (using drugs)
For less than 7 weeks: At this stage suction & curettage can be performed but the chances of continuation of pregnancy increases as the fetus is very small & may be missed during currettage.
Drug M (actual name not disclosed) and Drug P are the two drugs used. They are given orally or vaginally. Drug M blocks progesterone hormone from providing the shield necessary for continuation of pregnancy. Drug P stimulates contraction of the uterus. This combination of drugs causes abortion in about 95% of cases. Drug method is generally used for pregnancy less than 7 weeks old.

For Pregnancies more than 12 Weeks:

This is called second trimester abortion. This requires opinion of two Gynaecologists.

Drug P is used in higher doses. It is given orally or vaginally. Drug P stimulates contraction of the uterus.Once the baby and placenta are out a gentle curettage is done to ensure all the products of conception are removed.


Investigations to be done before MTP:
Hb,Cbc
Blood Group
Urine - Routine & Microscopy
Ultrasonography (to rule out abnormal & ectopic pregnancies)
Complications arising out of an abortion depend on length of the pregnancy and the method used. In general, longer the pregnancy, greater is the risk. In general drug method is riskier than the surgical evacuation. Abortion must be done at authorized clinics and hospitals. This is a very sensitive surgery. It should be done by a qualified Gynaecologist only.