Normal uterine anatomy (cut section)
Normal uterine anatomy (cut section)

Abortion - elective or therapeutic

Definition:
Elective or therapeutic abortion is the deliberate termination of a pregnancy.

Alternative Names:
Therapeutic abortion; Elective abortion

Causes, incidence, and risk factors:

Elective abortions are those initiated by personal choice. Therapeutic abortions are those recommended by the health care provider to protect the mother's physical or mental health. In the United States, one legal abortion occurs for every four live births.

Symptoms:

Early pregnancy symptoms include:

Signs and tests:

A pelvic examination is performed to confirm pregnancy and estimate the weeks of gestation. A serum HCG (blood test) may be performed to confirm pregnancy. An ultrasound (vaginal or abdominal) may be used to determine gestational age and location.

Treatment:

Most elective abortions take place between 8 and 12 weeks of gestation. The procedure consists of dilating the cervix and removing the contents of the uterus by suctioning the inner walls of the uterus.

Pregnancies prior to 7 weeks of gestation may be safely terminated using a combination of medications. A surgical procedure may therefore be avoided.

Expectations (prognosis):

Legally performed abortions are relatively safe. Complications rarely occur. A first trimester legal abortion is physically safer for a woman than actually giving birth.

Complications:

Excessive loss of blood, uterine perforation and infection, and an incomplete abortion are the most frequent complications. These complications are rare when the procedure is performed legally by a competent provider in an adequate facility.

Teenagers may not be aware that they are pregnant until the second trimester and could increase the danger to their own lives with second-trimester abortions. Infection resulting from the procedure occurs most commonly in women who have a preexisting gonorrheal or chlamydial infection.

Calling your health care provider:

Call for an appointment with your health care provider if an unplanned pregnancy occurs and information is desired about the choice of elective abortion.

Call your health care provider if an elective/therapeutic abortion has been performed and vaginal bleeding continues beyond what was predicted or if you continue to have symptoms of pregnancy or any severe pain. (Excessive bleeding can cause shock and continued pain or pregnancy symptoms may indicate a possible ectopic or tubal pregnancy.)

Call your health care provider if signs of infection develop, including persistent fever, foul odor to vaginal drainage, vaginal drainage that looks like pus, or abdominal pain or tenderness.

Prevention:

Improved methods of contraception can help prevent many unplanned pregnancies. This includes education related to abstinence, or, in the case of chosen sexual activity, contraception education.

Such methods will not totally alleviate the perceived need, since unplanned pregnancies occur even when couples practice adequate methods of contraception to the best of their abilities.

Some women chose to terminate a pregnancy that results from a sexual assault, or a pregnancy that endangers a woman's health, or when the fetus is abnormal.


Review Date: 1/27/2002
Reviewed By: Peter Chen, M.D., Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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