| An abortion by medical induction (medical termination of pregnancy) is the ending or termination of a pregnancy by a means other than surgery. Medical abortions are often performed using agents that induce abortion (prostaglandins, RU 486, methotrexate).
A medical abortion allows the woman to have an abortion without undergoing a surgical procedure, thus reducing the risk of puncturing (perforating) the uterus or tearing (lacerating) the cervix. The medical abortion can, however, be a slow and potentially ineffective method compared to surgical abortion. |
Source: Medical Disability Advisor
| Medical abortion may be recommended for conditions affecting either the woman or the fetus. Maternal indications for medical abortion include autoimmune disease, severe heart disease, cystic fibrosis, chronic kidney disease, sickle cell disease, diabetic retinopathy, cancer, intrauterine infection, premature rupture of membranes, and psychiatric illness. Medical abortion may be indicated if the fetus suffers from severe developmental defects that are incompatible with life such as absence of brain or spinal cord (anencephaly), spinal column or spinal cord anomalies, heart defects, or absence of kidneys (renal agenesis). |
Source: Medical Disability Advisor
| Medical abortion methods appropriate for early pregnancy (first trimester) involve giving agents that induce abortion (abortifacients) orally, intramuscularly, or vaginally. Before giving any medications, however, gestational age is verified by ultrasound. Prostaglandins are a group of fatty acid derivatives that have a marked effect on the uterus and can induce abortion. These are usually administered vaginally every 3 to 4 hours until abortion occurs.
Another agent that induces abortion is called RU 486. This agent competes against the hormone progesterone required to sustain early pregnancy. RU 486 is often used in combination with a prostaglandin that is administered vaginally or intramuscularly 36 to 60 hours after the administration of RU 486. The abortion usually occurs within 24 hours following prostaglandin administration. Methotrexate is a drug that affects rapidly dividing cells such as those within an embryo or early fetus and can be used in combination with a prostaglandin. Methotrexate is administered intramuscularly and followed within 1 to 7 days by vaginal administration of prostaglandin. The abortion should occur in 1 to 2 days but may take up to 4 weeks. Using this technique, the pregnancy should not have progressed more than 7 weeks from the patient's last menstrual cycle.
When the pregnancy is between 3 to 6 months (second trimester), an abortion can be initiated by injecting an abortifacient into the fluid-filled sac (amniotic sac) that holds the fetus (intra-amniotic instillation). Abortifacients used for intra-amniotic instillation include solutions of glucose, urea, saline, or prostaglandins. Spontaneous labor and expulsion of the fetus and placenta occurs within 16 to 22 hours after injection of the abortifacient. |
Source: Medical Disability Advisor
| Prostaglandins have an excellent effectiveness rate for inducing abortion. Over 85% of women on the mifepristone (RU 486) and prostaglandin regimen abort within 24 hours. Less than 1% require surgical intervention (suction curettage).
The methotrexate and prostaglandin regimen has a success rate of 90% to 93%. Approximately 5% will require surgical abortion because of a failed or incomplete abortion. Intra-amniotic instillation has a high success rate.
Aside from those who develop complications, most women recover physically within a few days. |
Source: Medical Disability Advisor
| Complications include excessive or long-term bleeding (hemorrhaging), infection, retention of tissue in the uterus, delivery of a live fetus, and failure to terminate the pregnancy. Uterine infection (endometritis) occurs in 5% of intra-amniotic instillations and can lead to infertility. Prostaglandins can cause vomiting and diarrhea. Methotrexate can cause nausea, diarrhea, and vomiting and, rarely, hair loss (alopecia) and bone marrow suppression. High doses of methotrexate can damage the kidneys or gastrointestinal lining. Abortions generally may have a severe psychological impact on the involved individuals. |
Source: Medical Disability Advisor
| Time off for follow-up medical appointments may be necessary, especially with RU 486. The woman may need to temporarily refrain from engaging in strenuous physical activity including heavy lifting. The psychological impact of therapeutic abortion can be considerable and may temporarily affect work performance. Psychotherapeutic counseling may be necessary. A temporary part-time work schedule may also be beneficial in some situations. |
Source: Medical Disability Advisor
| Elam-Evans, Laurie D., et al. "Abortion Surveillance --- United States, 2000." Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. 20 Sep. 2004 <http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5212a1.htm#tab10>. |
Source: Medical Disability Advisor