In the course of the article, the main characteristics of pharmacological abortion and the cases in which it can be used, the possible side effects that can be encountered and the contraindications to the implementation of this particular treatment will be analyzed.
Did you know that ...
Pharmacological abortion is often also referred to as "contragestion".
of the "AbortionVoluntary termination of pregnancy - by resorting to pharmacological and non-pharmacological abortion - in our country, is permitted and regulated by law 194. However, doctors opposed to this type of practice can appeal to conscientious objection, refusing the prescription and the administration of the drugs necessary for the interruption of gestation.
Despite this, the Court of Cassation has ruled out the possibility of raising conscientious objection in the phase of expulsion of the embryo, during which the doctor - even if he is a conscientious objector - is required to assist the patient as it is a matter of medical assistance provided after the termination of pregnancy.
Simplifying, if a woman has already taken the drugs necessary for the pharmacological abortion or has already undergone a surgical abortion, the medical staff present at the moment in which the expulsion of the embryo and of the material contained in the uterus and present in the stages subsequent to the removal of the embryo sac, it is compulsory to provide health care, even if it is a conscientious objector.
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In some cases, pharmacological abortion can also be used to carry out the therapeutic termination of pregnancy (therapeutic abortion) beyond the third month of gestation.
Clearly, given the delicacy of this medical procedure, the doctor must inform the patient about all the potential risks and, before proceeding with the treatment, must ensure that there are no contraindications or restrictions of any kind to the use of the drugs that will be used. to use.
®). Also known as the "abortion pill" and with the abbreviation "RU486", mifepristone is a synthetic steroid with antiprosgestinal activity.
Did you know that ...
Mifepristone is not only used for pharmacological termination of pregnancy, but also in the following situations:
- To dilate the cervix in preparation for surgical abortion;
- To induce labor in the event of intrauterine fetal death.
In any case, the anti-progestin action of mifepristone is exerted through the interaction with the progesterone receptors: mifepristone binds to them, thus competing with progesterone and hindering its activity.
Progesterone plays a fundamental role in the early stages of pregnancy, since:
- It makes the endometrium suitable for receiving the embryo and allowing its development;
- Promotes relaxation of the myometrium during gestation;
- It increases the nutritional capacity of the blood vessels present in the uterus and used to nourish the embryo.
With the intake of mifepristone, the aforementioned mechanisms are lacking, in this way the growth of the embryonic sac is blocked and its detachment "en bloc" is determined.
Please Note
The abortion pill based on mifepristone should NOT be confused with the morning after pill which, instead, represents an emergency contraceptive method.
Prostaglandin analogs
Prostaglandin analogues are usually administered 36-48 hours after taking mifepristone. Generally, misoprostol is used, but gemeprost can also be used in the context of pharmacological abortion. Misoprostol is administered orally in tablet form; while gemeprost is administered vaginally in the form of eggs.
The task of the prostaglandins is to induce uterine contractions to favor the expulsion of the embryo, the sac and the amniotic fluid and the initial placenta.
®), is available in the form of vaginal suppositories. The dose used corresponds to 1 gram of active ingredient.After the administration of both drugs, the medical staff will have to provide the woman with all the necessary assistance.
Result
The outcome of the pharmacological abortion is checked through an ultrasound scan which must be performed 14 days after the treatment.
The studies carried out and the data collected so far have shown that pharmacological abortion is effective in 95.5% of cases.
However, in the uncommon event that the expulsion of the embryonic sac does not take place completely, it is necessary to resort to scraping.
of different intensity (it is due to uterine contractions and is, for this reason, considered normal);Other possible side effects of greater seriousness that, in reality, could be considered as complications of the treatment, consist of:
- Metritis;
- Pelvic inflammatory disease.
Clearly, those reported above are just some of the side effects that can occur after the administration of the abortion drug and the prostaglandin analogue. Furthermore, it should be noted that the type and intensity of the side effects may vary according to the week of gestation during pregnancy. which drugs are taken, according to the individual sensitivity of each woman to the drugs administered and, even, according to the emotional and psychological conditions in which the patient finds herself.
Please Note
Given the delicacy of the situation and the emotional and psychological implications that the drug abortion can have on the woman, the family, the partner and the health personnel themselves should provide her with all the necessary support and support, both before, during and after the treatment.
known to any of the active ingredients or excipients contained in the drugs used for this type of treatment;
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