Surgical Termination of Pregnancy
Surgical termination of pregnancy is the clearance of the uterus using a simple surgical procedure. In early pregnancy the gestational sac is small and uterine clearance is relatively straightforward when conducted by an experienced clinician who has been specially trained.
The procedure may require dilation of the cervix which is undertaken after the woman has been sedated and local anaesthetic administered to the cervix itself. When the patient is comfortable and under conscious sedation, and after the cervix has been dilated using serial dilators, a suction catheter is introduced into the uterus and the uterine contents are removed.
The uterus often contracts down very well after the procedure, resulting in minimal or no blood loss. After a surgical termination of pregnancy, women can expect to have no bleeding, some light bleeding, or bleeding that starts and stops. Occasionally there is some debris left in the uterus after a surgical termination which usually resolves with the first period which typically comes 4-6 weeks after a surgical termination.
After the pregnancy has been removed, the procedural doctor will check personally to ensure that the products of conception have been successfully removed from the uterus. An ultrasound scan will be performed before and after the procedure and the images saved in her file. The woman is taken to recovery where she is cared for and closely observed whilst she recovers. She may initially have some cramping as the uterus contracts down, but this usually settles quickly and may occasionally require the use of some simple, over-the-counter pain relief.
The procedure for a mid-trimester termination of pregnancy is slightly different and requires a D and E (Dilatation and Evacuation).
Surgical termination of pregnancy up to 20 weeks is undertaken at Clinic 66. After 15 weeks of gestation, it is likely that the patient will require a two-day procedure. These two-day procedures are undertaken in order to minimise risks to the woman and require two attendances on consecutive days to the clinic.
For further information regarding mid-trimester termination of pregnancy please call 9411 3411 or contact us online.
Medical Termination of Pregnancy
With medical termination of pregnancy, the woman has had her early pregnancy confirmed by the doctor in the clinic who prescribes the medication. This will require an ultrasound examination to ensure that she has a gestation of 63 days or less (9 weeks).
The termination process begins after the woman is fully informed and signs a consent form. The first step of the termination process requires taking one tablet, which is usually done with the doctor. This tablet is Mifepristone, otherwise known as RU486. This tablet is a progesterone antagonist and blocks the hormone receptors on the developing pregnancy, causing the pregnancy to cease its growth.
Often a woman will not feel any different having taken the Mifepristone tablet, although sometimes she may feel less pregnant, and she may have some spotting.
The second lot of tablets are Misoprostol and 4 tablets are taken buccally (absorbed between the gums and the cheek). Within an hour of this second step, the woman will experience some cramping and some bleeding which may continue for six to seven hours.
For this second stage, we recommend that the woman is at home or somewhere where she feels comfortable and safe and that she has a support person with her to look after her. The woman should also be provided with support telephone numbers that she may call if she has any questions.
After about seven hours of the second step, the medical termination is usually complete, and the woman may resume her normal activity. For the 12 hours following the second step, we do not recommend that she makes any plans to go out, work, or receive visitors, as she will just need to stay at home and allow the process to occur.
Medical termination of pregnancy is essentially the induction of a miscarriage, and it’s very important that the woman has a follow-up two to three weeks after the medical termination to ensure that it has been completed.