Contraindications for Medical Abortion: Important Considerations

Introduction:

Medical abortion, also known as the abortion pill, is a non-invasive method to terminate an early pregnancy. It involves using medications, such as mifepristone and misoprostol, which are effective and safe when administered under medical supervision. However, like any medical procedure, there are specific contraindications that need to be considered before deciding to proceed with a medical abortion.

Understanding Contraindications:

Contraindications are specific medical conditions or situations where a treatment or procedure may be harmful or pose risks to an individual. It is crucial to be aware of these contraindications before opting for a medical abortion, as they can affect the outcome and potentially jeopardize the patient’s health.

Absolute contraindications

The absolute contraindications list is not very long, but must be strictly followed. “Absolute” means that medical abortion is strictly prohibited in the situations below.

1. Ectopic pregnancy: An ectopic pregnancy occurs when the fertilized egg implants outside the uterus, typically in the fallopian tubes. Medical abortion is not suitable for this condition, as it can increase the risk of rupture and internal bleeding. Ectopic pregnancies require immediate medical intervention.
2. A pregnancy that has occurred while using an intrauterine device (IUD). The IUD must be removed.
3. Infectious inflammatory processes in the gastrointestinal tract or reproductive organs, Infectious inflammatory processes in the acute stage. Adequate treatment is necessary.
4. Chronic adrenal failure: Individuals with chronic adrenal failure, also known as Addison’s disease, should avoid medical abortion. The hormonal changes induced by the medication can worsen their condition and lead to an adrenal crisis.
5. Inherited porphyria: Porphyria refers to a group of rare genetic disorders that affect the production of heme, a component of red blood cells. Inherited porphyria can make medical abortion unsafe, as the medication can trigger a porphyria attack, causing severe complications.
6. Coagulation disorders: Medical abortion can increase the risk of bleeding. Therefore, individuals with bleeding disorders, such as hemophilia, or individuals taking anticoagulant medications should avoid medical abortion as it might exacerbate bleeding complications.
7. Allergies or hypersensitivity: If an individual is known to be allergic or hypersensitive to mifepristone, misoprostol, or any other components of the medications used in medical abortion, it is strongly recommended to avoid this procedure. Allergic reactions can range from mild to severe and can lead to life-threatening complications.

Relative contraindications

Below is a list of relative contraindications to abortion pills. “Relative” means that MTP must be performed cautiously if the conditions listed below exist.

• Women over 35 who smoke more than ten cigarettes a day belong to the relative restrictions group.

Often, abnormal processes in the clotting system occur in this patient category, resulting in more prolonged and more intense bleeding. A consultation with a general practitioner should precede medical abortion services.

• Uterine myoma. MTP is possible only after a gynecologist nodule, the relevant opinion size, and an objective localization examination.
• Breastfeeding mothers should stop breastfeeding for seven days after Mifepristone administration (if 200 mg dosage is used, the period increases with higher dosages).

In progress, spontaneous abortion (miscarriage) is not a contraindication to the Mifepristone+Misoprostol complex. In this condition, the complex will ensure the fetal egg’s accelerated release within complete abortion has a reduced chance.

Seeking Medical Advice:

It is essential to consult a healthcare provider before deciding on a medical abortion. They will assess your medical history, perform necessary examinations, and discuss any contraindications or risks associated with the procedure.

Conclusion:

While medical abortion is generally considered safe and effective, it is crucial to be aware of the contraindications that may affect its suitability for an individual. Understanding and recognizing these contraindications before proceeding with a medical abortion is a responsible step to take. Always consult a healthcare professional who can provide tailored advice based on your medical history, ensuring your safety and well-being throughout the process.

Author

Dr. Kopp Kallner. M.D. in Obstetrics & Gynecology, Columbia University Medical School.