Pregnancy after abortion of
It is known that artificial interruption of pregnancy (abortion) always affects on reproductive health of the woman. Not incidentally doctors pay special attention to future mothers who in the past transferred abortions. In this article it will be a question of how abortion can influence emergence and the course of the subsequent pregnancies.
Abortion is not always the choice of the woman. Its reasons can be and medical (a serious illness of internals, nervous system, including oncological defeats). However anyway abortion can have negative consequences.
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Medical abortion (classical, tool abortion) - removal of fetal egg with a simultaneous scraping of walls of a uterus.Medical abortion is carried out by
on pregnancy terms till 12 weeks. Optimum for carrying out abortion the term of 6 - 7 weeks is. Abortion is carried out by the doctor, in a hospital.
For penetration into a cavity of a uterus makes expansion of its channel by special dilators. For removal of fetal egg of a wall of a uterus scrape out the tool - the curette. Medical abortion is carried out under anesthetic. Several hours after abortion the woman are under supervision of the doctor. At a favorable current after the operational period the patient is written out home on the same day.
Medical abortion, despite the seeming simplicity, is one of the most difficult gynecology of operations.
to infertility and if pregnancy came, then the following complications are possible.Threat of interruption of the subsequent pregnancy
during abortion such complication as an injury of a neck of a uterus from which results istmiko - tservikalny insufficiency - a state at which the neck of a uterus does not carry out the holding function is probable
. If normal the uterus neck during all pregnancy remains closed that is an important factor for deduction of fetal egg in a uterus cavity, then at istmiko - tservikalny insufficiency this function is broken. The neck of a uterus is a muscular education which can be damaged during abortion by the surgical tool. At the same time the anguish is formed, it also leads to the fact that the neck of a uterus becomes functionally defective. This complication meets more often when the first pregnancy comes to an end with abortion as the channel of a neck of a uterus in these cases very narrow, badly extends surgical tools. Istmiko - tservikalny insufficiency is shown by pregnancy interruption, is more often in 16 - 18 weeks. At the same time there are bloody allocations from a genital tract, insignificant skhvatkoobrazny pains in the bottom of a stomach are possible, but is more often than pains does not happen. Then fetal egg leaves a uterus, there is an abortion.
It is complication it is possible to prevent, foreknowing about inferiority of a neck of a uterus. For this purpose on a neck of a uterus impose seams which hold it in the closed state. Trouble is that istmiko - tservikalny insufficiency is often diagnosed when the abortion already happened and adequate treatment is possible only during the subsequent pregnancies. If the doctor has data on existence of injuries of neck of a uterus during the previous abortion, then he will in due time perform inspection of a neck of a uterus, will appoint ultrasonic research during the critical period.
also change of hormonal regulation can be the Cause of an abortion after abortion. Pregnancy is a state during which an organism, all its systems are reconstructed for ensuring normal growth and development of a fruit. At artificial interruption of pregnancy normal work of endocrine bodies - a hypophysis, ovaries, etc. can be broken. It will lead to the fact that during the following pregnancy the fruit will not be provided with the corresponding hormonal support. As a rule, it is expressed in a lack of hormone of a yellow body - the progesterone playing a key role for preservation of pregnancy in the first trimester. This complication, perhaps to eliminate, accepting the corresponding medicines which will be appointed by the doctor.
the Wrong attachment of fetal egg
as a result of abortion is injured and becomes thinner an inside layer of a uterus - endometry, that layer to which fetal egg is attached. The condition of an inside layer plays a huge role for the correct formation of a placenta. In the presence of thinnings, sites of a chronic inflammation, solderings (connecting fabric which is formed as a result of an inflammation in a uterus cavity) fetal egg is attached to that place on a uterus wall where there are no these damages. Often such sites are located in the lower departments of a uterus that leads to a low arrangement of a placenta, to prelying of a placenta - at the same time the placenta blocks an exit from a uterus neck, even the attachment of fetal egg not in a uterus, and in a uterus neck - so-called cervical pregnancy is possible. All these states are fraught with developing of the bleeding connected from an otsloyky placenta, and cervical pregnancy in general can become a reason for removal of a uterus from - for massive bleedings; it is impossible to inform of such pregnancy the end, and at cervical pregnancy the fruit is always deleted.during pregnancy often should carry out by
When prelying and a low attachment of a placenta the hospitalization directed to pregnancy preservation; the probability of a rodorazresheniye by operation of Cesarean section increases.
a fruit Growth inhibition
Because as it was already noted, after the previous abortions the inside layer of a uterus can become defective, formation of defects when forming a placenta is possible that, in turn, leads to insufficient intake of oxygen and nutrients to a fruit. Such state is called fetoplatsentarny insufficiency. As a result the fruit lags behind in growth pregnancy term, the birth of the small baby is possible.
In this regard it is especially important to watch during pregnancy growth rates of a fruit. The doctor does it on each reception, measuring the stomach sizes, and also during ultrasonic researches.by
When diagnosing a growth inhibition of a fruit spends special treatment at home or in a hospital.
the Rupture of a uterus
This terrible complication is possible
at considerable thinning of a wall of a uterus after a large number of abortions or if during abortion perforation of a uterus - formation of a through opening is made. If during abortion there was such serious complication, then to the woman do operation, restoring integrity of a wall of a uterus, or if defect insignificant, is made observation and treatment without operation. Anyway on the place of perforation connecting fabric is formed, it is few rastyazhima, and there can be a rupture of a uterus during pregnancy or at the time of delivery, at the same time considerably suffer both mother, and the kid. It is clear, that the pregnant woman having such feature demands especially careful supervision.
the Rhesus factor - a sensitization
So call a state at which in an organism of the woman are developed a Rhesus factor - antibodies to fruit erythrocytes - the red blood cages transferring fruit oxygen. This complication can arise after abortion only at the women having blood with negative a Rhesus factor - a factor in case the fruit was with a positive Rhesus factor. During abortion a large number the Rhesus factor - positive erythrocytes of a fruit can get to mother`s blood-groove that will cause formation of a large number of antibodies. The formed antibodies remain in the woman`s organism, can exert the harmful impact on a fruit during the subsequent pregnancies a Rhesus factor - a positive fruit.by
developed emergence prevention a Rhesus factor Now - a sensitization after abortions and childbirth. It includes introduction to the woman of a special preparation - an anti-Rhesus factor - immunoglobulin. This preparation destroys mothers who remained after abortion in a blood-groove a Rhesus factor - positive erythrocytes of a fruit, without allowing to be started thereby to actually maternal immune answer (development of maternal protivorezusny antibodies). It is desirable that this drug was injected within 2 hours after abortion, but its introduction is admissible till 72 o`clock.Should note
that anti-genes of system a Rhesus factor (that is actually a Rhesus factor - a factor) contain in fruit blood with 7 - 8 - y weeks of pregnancy, that is formation of antibodies is possible in the pregnant woman`s organism if abortion was made after 6 - y weeks of pregnancy, before the probability a Rhesus factor - a sensitization is absent.by
What existence of antibodies in the woman`s organism is dangerous to a fruit? Getting to a fruit blood-groove, a Rhesus factor - antibodies destroy its erythrocytes, causing anemia (decrease in hemoglobin), violation of functions of vitals and systems of a fruit (disintegration of erythrocytes leads to injury of a liver, kidneys, a fruit brain). Such state is called a hemolytic illness. In the most hard cases it comes to an end with pre-natal death of a fruit on various terms of pregnancy, in more mild cases a Rhesus factor - the conflict is shown after the birth by jaundice or anemia of the newborn.
All pregnant women having a negative Rhesus factor and the more so - pregnant women in whom antibodies are found are on the special account in a maternity welfare unit they regularly take a blood test in order that it was possible to define whether are developed during the current pregnancy new antibodies. The researches (ultrasonography, KTG, a doppler) allowing to watch a condition of the kid are conducted. At increase of quantity of antibodies and at a serious condition of a fruit perhaps pre-natal blood transfusion (under control of ultrasonography through a forward belly wall of mother get into a vein of an umbilical cord and pour to a fruit 20 - 50 ml of eritrotsitarny weight). This operation improves a condition of a fruit and allows to prolong pregnancy.
Many of the listed complications can be prevented or, at least, to minimize their negative consequences if the doctor knows about existence of the previous abortions. The doctor will appoint the corresponding researches, medicines for prevention of complications. Therefore it is not necessary to hush up the fact of existence of medical abortions at all.