Abortion hemostatic drugs

Abortion is not uncommon in current medicine. There are many types and methods of abortion. The more common ones are medical abortion and surgical abortion. Medical abortion does not require intrauterine curettage. Only a follow-up examination is required after the abortion. Many people wonder whether they should use hemostatic drugs during abortion? What should I use during a miscarriage? These are all worthy of our attention.

The advantages of medical abortion are that the method is simple, does not require intrauterine operation, and is non-traumatic. Since the 1990s, drugs for medical abortion have become increasingly sophisticated. The more mature and commonly used methods are mifepristone and prostaglandin, with a complete abortion rate of over 90%.

How it works

Mifepristone has an anti-progesterone effect. Its affinity for the endometrial progesterone receptor is significantly higher than that of progesterone. Therefore, it can compete with the progesterone receptor in the decidua, block the activity of endogenous progesterone, and interfere with pregnancy. Due to the necrosis of the decidua during pregnancy, endogenous prostaglandins are released, which promote uterine contraction, cervical softening and opening, and the expulsion of the fetal sac.

The prostaglandins used in my country are misoprostol and carboprost methyl suppositories; abroad there are also gemeprostol and sulfaprostone.

Different regions have slightly different regulations on the gestational age at which medical abortion can be performed. Taking Beijing as an example, women with a gestational age of less than 49 days can have a medical abortion in an outpatient clinic. However, patients with a gestational age of 10-16 weeks have a higher risk of bleeding during forceps curettage, so they have begun to use mifepristone combined with prostaglandins for medical induction of labor, but they need to be hospitalized.

Pre-medication treatment

1) The doctor should explain the medication method, efficacy and possible side effects to the patient, and the patient should make the choice voluntarily;

2) Physical examination and testing are the same as vacuum aspiration;

3) Explain the pros and cons of medical abortion to pregnant women and let them make the natural choice.

Directions

Mifepristone: Generally, the first dose is given in an outpatient clinic, and the rest can be taken home by the patient;

Prostaglandins: Patients are required to come to the hospital for medication and stay in the hospital for observation. Take it on an empty stomach on the morning of the third day, or insert it vaginally and stay in the hospital for observation for 6 hours.

Observation after medication

1) Pay attention to the duration and amount of vaginal bleeding after taking mifepristone. If there is a lot of bleeding or tissue is discharged, you should go to the hospital for treatment in time;

2) After using prostaglandins, the patient needs to stay in the hospital for observation to check blood pressure, pulse, diarrhea, abdominal pain, bleeding, whether the fetal sac is expelled, and any side effects of the medication. If some side effects are more obvious, timely symptomatic treatment can be given. And record it in detail;

3) After the fetal sac is expelled, a medical staff will carefully check the expelled material (the uterus will be cleaned at any time if there is a lot of bleeding), and the patient will be discharged after 1 hour of observation. Before leaving the hospital, the blood pressure and pulse will be measured, recorded, and the follow-up date and precautions will be given (2 weeks and 6 weeks after abortion);

4) Patients whose fetal sac has not been expelled will be discharged from the hospital within 6 hours and will be scheduled for ultrasound examination and follow-up within 1 week. If the abortion fails, artificial abortion vacuum aspiration will be performed;

5) On the 15th day of medication: All subjects were required to return for a follow-up visit 2 weeks after taking the medication. If the bleeding is more than the menstrual volume, you should go to the original hospital for examination. For patients diagnosed with incomplete abortion through B-ultrasound and HCG examination, uterine curettage should be performed as appropriate and the patient should be sent for pathological examination.