Is medical abortion at two and a half months considered induced labor?

Although young women today have a more open attitude towards sexual life, many of them do not know much about contraceptive measures, nor do they understand the difference between abortion and induced abortion. Many women choose to have an abortion after becoming pregnant because they cannot bear the pressure of pregnancy. Generally, more people choose medical abortion in the early stages of pregnancy. Medical abortion can remove the gestational sac from the body and the pain is relatively mild. So, is medical abortion at two and a half months considered induced labor?

Induced labor refers to the use of artificial methods to induce uterine contractions to end pregnancy after 12 weeks of pregnancy due to maternal or fetal reasons. According to the gestational age at the time of induced labor, it can be divided into mid-term induced labor (14 to 28 weeks) and late-term induced labor (after 28 weeks).

Preparation for induction of labor

The success of induced labor is related to various factors. Cervical maturity is an important factor in determining the success of induction of labor. If the cervix is ​​immature, induction of labor is often not successful. Most women with a mature cervix can give birth vaginally.

1. Cervical scoring

In 1964, Bishop developed a scoring system to determine whether pregnant women were suitable for elective induction of labor. The currently recognized method for estimating cervical maturity is the Bishop score. He believes that a score ≥ 7 indicates that the cervix is ​​mature. The higher the score, the more mature the cervix, and the easier it is to successfully induce labor. If the score is below 6, cervical ripening should be promoted.

2. Methods of promoting cervical ripening

The cervix is ​​mainly composed of epithelium, smooth muscle, connective tissue, glands and matrix. Cervical maturity is not necessarily proportional to gestational age, but is related to the biological changes in cervical tissue. After pregnancy, the cervical tissue changes, which become more obvious as the pregnancy progresses and reach a peak during delivery. The typical manifestations are: a significant decrease in collagen fibers, which are loose and reticular; blood vessels are dilated and congested; white blood cells accumulate and attach to the wall, and a large number of white blood cells and fibroblasts appear in the interstitium. Cervical ripening may be the result of the action of multiple hormones, such as estrogen, progesterone, relaxin and prostaglandins.

Methods of inducing labor

The ideal method of promoting cervical ripening is similar to its natural ripening process, will not cause excessive uterine contraction, will not affect uterine blood flow, and will not endanger the safety of the fetus and mother. There are many ways to promote cervical ripening, but there is still no perfect and effective method. Currently, the commonly used methods are divided into two categories: non-drug and drug:

1. Non-drug methods

① Artificial membrane stripping (basically not used); ② Artificial membrane rupture (not effective when used alone); ③ Water bag or Foley catheter (not routinely used); ④ Hygroscopic dilator or Lamicel rod (rarely used); ⑤ Nipple stimulation (not often used); ⑥ Acupuncture therapy (basically not used).

2. Drug therapy

① Oxytocin, small dose and low concentration intravenous drip; ② Prostaglandin PGE2 (routine use); ③ PGE2 gel intracervical administration (rarely used); ④ PGE2 vaginal controlled release tablets - Probeson (commonly used); ⑤ Misoprostol (not routinely used); ⑥ Vaginal placement of misoprostol; ⑦ Carboprostol suppository (basically not used); ⑧ Mifepristone (not used for late induction of labor).

Pre-labor induction check

1. Ask about the medical history in detail, including past history, bleeding history, history of liver and kidney diseases, menstrual history, pregnancy and delivery history, and the course of this pregnancy.

2. General and gynecological examination, routine leucorrhea testing.

3. Measure body temperature, pulse, blood pressure, blood test, urine routine, etc., and if necessary, measure liver and kidney function, chest X-ray, and electrocardiogram.

4. Severe cervicitis or heavy secretions require treatment first, and surgery can only be performed after the condition improves; antibiotics are given before surgery to prevent infection. If necessary, secretion culture and drug sensitivity test should be performed.

5. Patients who are in advanced pregnancy, have hypoplastic cervix, small cervical os, and long cervical canal need to be given certain medications before surgery.

6. Perform B-ultrasound to locate the placenta when necessary. It is contraindicated for patients with low-lying placenta.