When surgical termination of pregnancy is the only option

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When surgical termination of pregnancy is the only option ...

A surgical abortion involves the removal of the pregnancy, that is the foetus and it’s tissues, through the vagina by surgical means. Doctors commonly advise termination of pregnancy with surgical termination of pregnancy if the pregnancy is more than 8 weeks.

At which stage do doctors advise termination of pregnancy with surgery?

If the pregnancy is less than 12 weeks a vacuum is used to suck out the contents of the uterus. This is called suction aspiration. However, to reach the uterus with surgical instruments the cervix must be first dilated or widened. An injection is given into the cervix to numb it for the procedure. Then rods of increasing sizes are inserted into the cervix till the cervix is sufficiently widened. This process is called dilation.

Next, a cannula, which is a long plastic tube connected to a suction device, is inserted into the uterus. The uterus is then emptied of its contents by gentle suction.

What is the process of curettage?

Lastly, another scoop like or spoon shaped instrument called the curette is inserted to scrape out any remaining tissues of the pregnancy from the uterine lining. This is called curettage. The whole procedure takes about 10 to 15 minutes.

If the pregnancy is more than 12 weeks the procedure may be carried out under general anaesthesia. Also, the cervix is dilated differently. Medicines such as misoprostol may be given orally or inserted into the vagina about 2 hours before the operation to soften the cervix.

Are there any alternate methods?

Another method that may be used is to first dilate the cervix a bit and then insert an osmotic device called laminaria into the cervix. This absorbs moisture and swells over several hours until the cervix is sufficiently dilated.

The curette, and sometimes a forceps is used to remove the foetus and tissues. The last step is usually a final suctioning to make sure the contents are completely removed. The procedure normally takes between 15 to 30 minutes.

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