Abortion: Understanding Your Options and Rights

Miscarriage is defined as the spontaneous termination of pregnancy before 20 weeks of pregnancy. Early abortion happens before 12 weeks and late after that date.

The most common cause of abortions are embryonic malformations or chromosomal abnormalities. In many cases it is very difficult to identify the exact cause of the abortion, but there are some risk factors. The most important risk factor is maternal age, going from a risk of:

• 12% approximately at 20-30 years
• 15% between 30-35
• 25% at 35-40
• 30-50% from the age of 40.

The previous abortions they can increase the risk of later miscarriage. Although after a single abortion the risk modification is minimal, after 2 episodes the risk is 25% and after 3 it is 45%.

Causes that may contribute

Some habits like smoking, the intake of alcohol and the excess of coffee (more than 5 cups a day) increase the risk of miscarriage. Certain maternal pathologies they increase the risk of miscarriage, such as uterine malformations or blood clotting disorders.

Threatened abortion is defined as the genital bleeding during early pregnancy, with an unmodified cervix, without dilation, and with an ultrasound that corresponds to the expected image in case of normality. Occurs in a 20-25% of pregnant women and if a heartbeat is observed on ultrasound in more than 90% of cases, the prognosis is good. This bleeding does not increase the risk of fetal malformations. Treatment of threatened abortion, in the absence of risk factors, is relative rest and sexual abstinence.

Types of abortion

Ongoing abortion is diagnosed when the woman has bleeding, abdominal pain, and dilation of the cervix. The uterus is producing contractions which will inevitably lead to the expulsion of the embryo. If the expulsion of gestational material occurs in your whole (verified by ultrasound) is diagnosed of complete abortion without requiring further treatment. If on the contrary not all gestational tissue has been expelled It is an incomplete abortion and a subsequent curettage is necessary to prevent bleeding.

The deferred abort It is one in which gestational tissue is not expelled through the vagina but an interruption of pregnancy is verified by ultrasound. Treatment in these cases is usually the performance of a uterine curettage Or it can be expectant, although this last option is usually psychologically difficult for women and with a certain degree of risk of impaired coagulation.

The administration of the anti-D gamma globulin in Rh negative patients suffering an abortion. After an abortion, both complete and after performing a curettage, a period of 2-3 weeks of sexual abstinence is recommended, avoiding baths and the use of tampons. If everything evolves correctly, you can look for a new pregnancy after at least two months.

The hollow egg or anembryonic pregnancy It is an entity in which the gestational sac is observed in the ultrasound but without visualizing the embryo since it has stopped very early or has not developed. A hollow egg should be suspected from a 15-20 mm gestational sac without an embryo inside. Its treatment is the same as that of deferred abortion.

If they occur three or more miscarriages It is recommended to carry out a study of the two members of the couple to be able to rule out alterations that predispose to this pathology and that are treatable.