Suction curettage

Alternative names
Induced abortion; Abortion; Surgical abortion; Medical abortion

Definition
An abortion is a procedure, either surgical or medical, to end a pregnancy by removing the fetus and placenta from the uterus.

Description

A surgical abortion that is performed between 6 and 12 weeks into a pregnancy may be done while the woman is awake. She is given the option of being sedated by medications, or having her cervix numbed with an injection of anesthesia so that she is basically pain-free.

A surgical abortion for a pregnancy over 12 weeks is usually done while the woman is sedated, although it can also be performed while the woman is awake. The cervical canal is enlarged (dilated) and a hollow tube is inserted into the uterus.

A vacuum (suction) machine is used to remove the tissues (fetus and placenta) from the uterus. Medicines such as oxytocin are sometimes given to cause the uterine muscles to contract and reduce bleeding.

An abortion can be performed non-surgically for a pregnancy less than 7 weeks from the first day of the last menstrual period using a combination of medications. The current regimen approved by the FDA includes administration of one dose of Mifepristone (RU486), an antiprogestin, followed by one dose of Misoprostol, a prostaglandin analogue two days later. These medications may be given in the doctor’s office, after a thorough history and physical is performed.

Indications
There are several reasons an abortion might be considered:

     
  • The woman may not wish to be pregnant (elective termination)  
  • The woman’s health is endangered by pregnancy (therapeutic abortion)  
  • There is a chance of an abnormality in the developing fetus (birth defect, genetic abnormality)

The decision to have an abortion is an intensely personal one. Most health care providers recommend competent counseling before making this decision.

Because abortion is a controversial issue in the United States, many women who make such a decision feel as if they cannot share that information with others. Therefore, it is important for women who are contemplating an abortion to examine their existing support system and identify those people who may be capable of helping them through what may be a difficult time.

It is also important that they choose a reputable provider or clinic that advocates choice for women, and is a safe environment in which they can obtain adequate counseling regarding all options for pregnancy resolution, have the procedure performed, and obtain the support and follow-up care that may be necessary after the abortion.

RISKS

The risks for any anesthesia are:

     
  • Reactions to medications  
  • Problems breathing

The risks for any surgery are:

     
  • Bleeding  
  • Infection

Additional risks of surgical abortion include:

     
  • Excessive bleeding  
  • Infection of the uterus  
  • Infection of the fallopian tubes (which can cause scarring and interfere with fertility (infertility)  
  • Puncture (perforation) of the uterus, or damage to the cervix (rare)  
  • Emotional or psychological distress

The risks of abortion using medication include:

     
  • Prolonged bleeding  
  • Incomplete abortion necessitating a surgical abortion  
  • Nausea  
  • Vomiting  
  • Diarrhea  
  • Pain

Expectations after surgery

Most women who undergo surgical abortions done in appropriate medical facilities recover without any physical complications.

Any significant emotional and psychological issues should be considered and addressed before and after a chosen abortion.

Convalescence

Physical recovery usually occurs within a few days, depending on the stage of the pregnancy. A small amount of vaginal bleeding and mild uterine cramping should be expected for a few days.

A hot bath or use of a heating pad or hot water bottle on the abdomen may help relieve discomfort. Strenuous activity should be avoided for a few days following an abortion. Tampons may be used after 3 days. Sexual intercourse should be avoided for 2 to 3 weeks. A normal menstrual period should occur 4 to 6 weeks after the operation.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.