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Medical examinations before surgical abortion

Medical examinations before surgical abortion. Moscow Regional Research Institute of Obstetrics & Gynecology Olga Serova, MD, professor. Abortions and deliveries in Moscow Region. Girls up to 14 years 2002г. – 0,11%; 2003г. – 0,08%. Modern Technologies of Induced Abortion.

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Medical examinations before surgical abortion

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  1. Medical examinations before surgical abortion Moscow Regional Research Institute of Obstetrics & Gynecology Olga Serova, MD, professor

  2. Abortions and deliveries in Moscow Region Girls up to 14 years 2002г. – 0,11%; 2003г. – 0,08%.

  3. Modern Technologies of Induced Abortion • Surgical abortion • Vacuum aspiration (mini-abortion) • Medical methods (mifepristone)

  4. Early abortion complication • Cervical trauma • Incomplete abortion / Failed abortion • Haemorrhage • Uterine perforation

  5. Maternal mortality in Moscow Region

  6. Abortion Complication 14% 12% 10% 8% 6% 4% 2% 2% 0% Haemorrhage Endometritis Incomplete abortion

  7. Risk Factors in developing of abortion complications • Chronical inflammatory diseases • STI • Scar utery • Leomyoma uterus • Frequent changes sex partners • Operations in women’ hystory

  8. Rehabilitation after abortion • Before abortion • During abortion • In early post-abortion period • Long-term period

  9. Pre-abortion care • Confirming the pregnancy • Physical examination and pre-existing conditions • Information and counseling

  10. Physical examination before abortion • Ultrasound scanning • Measuring haemoglobin and haematocrit (Нв, Ht) • Tests for ABO and Rhesus (Rh) blood group typing • Tests for RW, HIV, HbsAg, HCV • Laboratory testing for RTIs • Cervix Cytology • Others – in special indications

  11. Ultrasound scanning • Confirm pregnancy and estimate its duration • Detection of ectopic pregnancy • Pre-existing conditions (leiomyoma uterus, abnormalities etc) • Intrauterine device

  12. Blood Laboratory Testing • Measuring hemoglobin and haematocrit – to detect anemia and blood diseases • Tests for ABO and Rhesus (Rh) blood group typing – for anti-D immunoglobulin injection • Tests for RW, HIV, HBsAg, HCV – for prevention abortion complication

  13. For excluding RTI • Bacterioscopy is not enough information • RTI – for inflammatory diseases diagnostic’s

  14. Rehabilitation during abortion • Methods of abortion • Abortion clinics or facilities • Pain management • Emergency treatment

  15. Rehabilitation in post-abortion period • After medical abortion – 2 hours observation, ultrasound – in 7-10 days • After surgical abortion - observation in a hospital,physical examination and ultrasoundbefore discharge

  16. Inflammatory Diseases Prevention Vacuum aspiration Medical abortion Surgical abortion • Chomical inflammatory • diseases • Uterus’ scar • Repeated operative • treatment in women’s life • Pre-existing STI • Colpitis • Bacterial vaginosis • In any cases

  17. Inflammatory Diseases Prevention • After medical abortion – Cefuroxim 150 mg (one dose) • During vacuum aspiration - Cefuroxim 150 mg(one dose) • After surgical abortion –antibiotics prevention courses during 5-10 days

  18. Effectiveness prevention' programs after abortion (1 year follow-up)

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