Medicines in the context of medical abortion
The medical abortion can now be practiced medicine “city” , that is to say, by a general practitioner, a gynecologist, a midwife, health center or central planning and family education. This method cannot be used beyond 7 weeks of absence of periods . In hospital or in a clinic, Abortion tablets in Dubai can be performed for up to 9 weeks without a period.
Concretely, the woman will make an initial consultation with her doctor or midwife who will inform her of the different techniques and offer her a psycho-social interview (if you are a minor, it is compulsory). From now on, there is no longer a cooling-off period. Thus, you can be informed and make your decision during the same consultation (except for minors who have a period of 48 hours after the psycho-social interview) or choose to do so during two different consultations . Finally, during the third (or second) consultation, a tablet of m ifepristone ( Mifégyne ®) will be administered to him .
The Mifepristone has a molecular structure very similar to that of the steroid hormones and binds with high affinity to the progesterone receptor. It then has a real antiprogesterone effect and acts in particular on the pregnant uterus by causing softening of the cervix, an increase in the contractility of the uterine muscle and promotes detachment of the embryo. The dose recommended by the HAS is 600 mg (i.e. 3 tablets of 200 mg) but some abortion centers do not respect these doses.
36 to 48 hours after taking mifepristone orally, the woman should take the misoprostol ( Gymiso ®) tablet . This drug is an analogue of prostaglandin. It causes contractions and triggers the expulsion of the egg. The dosage recommended by the ANSM is 400 micrograms, or 2 tablets taken by mouth.
Finally, a control visit is compulsory 14 to 21 days later .
If this method is effective in 95% of cases , in 1% of cases, the pregnancy is progressive. That is to say, it continues normally. In 5% of cases, the expulsion is not complete after 3 weeks and ends naturally a few days later. In very rare cases, it must be supplemented by absorption.
Medicines for medical termination of pregnancy
Mifepristone has also profoundly altered the achievement of medical terminations of pregnancy (IMS) . The Mifégyne® tablet makes it possible to prepare the cervix and the uterine muscle for the action of prostaglandins which are used to obtain contractions and cause the expulsion of the malformed fetus. In practice, Mifégyne® tablets are taken two days before the scheduled hospitalization for the therapeutic termination of pregnancy . This makes it possible to significantly reduce the doses of prostaglandins required for expulsion.
In the event of the fetus dying in utero , the pregnancy does not always end naturally and it is often necessary to speed up the labor and expulsion of the fetus, in particular in order to avoid infections. Taking Mifégyne ® tablets is then indicated to facilitate the action of prostaglandins . Often, under these conditions, RU 486 is sufficient to induce labor .
Medicated abortions: what level of pain?
The medical abortion causes pain (the peak of which is felt on D3 of the abortion, that is to say the day of the taking of the second medication). These pains must be taken care of by the prescription of analgesics (level I or even II if necessary).
Women describe severe or even very severe pain in 25% of cases (greater than 8 on a scale of 10). According to the study carried out by Inserm, three factors influence the level of pain experienced. It is generally stronger:
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