First Trimester Termination Of Pregnancy

First trimester termination of pregnancy (TOP) is considered a safe and effective procedure. The two main options for first trimester TOP are either medical treatment – misoprostol alone or with mifepristone; and surgical treatment – vacuum aspiration (VA).

First trimester termination of pregnancy (TOP) is considered a safe and effective procedure. The two main options for first trimester TOP are either medical treatment – misoprostol alone or with mifepristone; and surgical treatment – vacuum aspiration (VA). Medical treatment is cost-effective, has a lower failure rate, especially when used within 9 weeks of gestation, and can be performed at home. However, it may cause more cramping and bleeding than surgical treatment.

The decision to terminate a pregnancy is a difficult one and it is important that you make an informed choice. First trimester termination of pregnancy (TOP) is considered a safe and effective procedure. The two main options for first trimester TOP are either medical treatment – misoprostol alone or with mifepristone; and surgical treatment – vacuum aspiration (VA).

First trimester TOP, is considered a safe and effective procedure. The two main options for first trimester TOP are either medical treatment – misoprostol alone or with mifepristone; and surgical treatment – vacuum aspiration (VA).

The two main options for first trimester TOP are either medical treatment – misoprostol alone or with mifepristone, or surgical treatment – vacuum aspiration (VA). Both are considered safe and effective procedures.

First Trimester Termination of Pregnancy Misoprostol

First trimester termination of pregnancy (TOP) is a safe and effective procedure. The complete abortion rates of surgical and medical abortion are approximately 97% and 95%, respectively. Vacuum aspiration (VA) either by electrical suction or manual aspiration is the method of choice for surgical TOP. Risk of significant bleeding is ≤ 5% in VA, while major complications occur in <1%. The risk of infection after VA can be reduced significantly by using prophylactic antibiotics or by the screen-and-treat strategy. Pre-operative administration of misoprostol can also reduce the risk of complications. The combination of 200 mg mifepristone followed by 800 μg misoprostol 24–48 h later is recommended for first trimester medical TOP. If mifepristone is not available, misoprostol can also be used alone, but repeated doses may be required and the complete abortion rate may be lower. Due to the reduced efficacy in more advanced gestation, repeated doses of misoprostol may be required for medical TOP over 9 weeks of gestation. The complete abortion rate with this regimen is 95% or more. Gastrointestinal upsets can occur in up to 50% of women, but major complications are rare. There was no lower limit of gestational week for TOP, although extra precaution is required for the confirmation of completion of procedures and exclusion of ectopic pregnancy.

First trimester termination of pregnancy (TOP) means ending a pregnancy before the 12th week of pregnancy. Abortion by medical methods is an option for women who are past the first trimester of their pregnancies. Medical methods include taking medication to end a pregnancy, or having a procedure to end it. Surgical procedures are used when medical methods cannot be used, or when they have failed.”

The two main options for first trimester TOP are either medical treatment – misoprostol alone or with mifepristone, or surgical treatment – vacuum aspiration (VA). Medical methods are most often used during the initial consultation, so that surgical methods can be delayed until the person is ready to proceed.

First trimester termination of pregnancy (TOP), is a common and safe procedure. Some of the options available are medical treatment – misoprostol alone or with mifepristone; vacuum aspiration (VA) and surgical treatment – dilation and curettage (D&C). There are many advantages to having an early termination when compared to waiting until the second trimester.

Can Misoprostol Alone Abort 4 Weeks Pregnancy

Early abortion at a glance

  • An early abortion is the termination of a pregnancy during the first trimester (the first 3 months of pregnancy).
  • Early abortions can be accomplished with medication or surgery.
  • Early abortions require less care and follow-up and are significantly more affordable than later abortions.

What is an early abortion?

An early abortion is the termination of a pregnancy during the first trimester (within the first 12-14 weeks of pregnancy). Compared to later abortions, early abortions require less medical attention and follow-up, which makes them significantly more affordable than later abortions.

A pregnancy is in its earliest stages during the first trimester, which provides a variety of abortion options. Early abortions can be performed with surgery or with medication if the pregnancy is less than 10 weeks (measured from the first day of the last menstrual period, and confirmed with ultrasound in our clinic). Having the option of a medical abortion, also called a medication abortion, is a specific benefit of early abortions. After 10 weeks, abortion with medication alone is not feasible, and terminating a pregnancy at this stage requires a surgical procedure.

How is an early abortion performed?

Early abortions in the first trimester can be accomplished with either medication or surgery. Both medical and surgical abortion are safe and effective for most patients. Patients can discuss both options with our physicians, and choose the best method for them.

Compare medication abortion vs. surgical abortion

Medication abortion

At the Comprehensive Women’s Health Center (CWHC), we offer medical abortions (medication abortions) for pregnancies up to 10 weeks gestation.

A medication abortion uses a combination of two drugs to end a pregnancy. The first drug is mifepristone (brand name Mifeprex), which is used to stop the growth of the pregnancy and weaken its attachment to the uterus. Most of the time this drug is taken in the clinic.

The second drug is misoprostol (brand name Cytotec), which is taken six to 48 hours after mifepristone. This drug is taken at home and causes the uterus to expel the pregnancy. Our doctors make sure that every patient knows exactly what to do and expect before they leave the clinic to complete the medication abortion process.

As the uterus begins to expel the pregnancy, cramping and bleeding occurs. It is often described as being similar to the stronger, heavier symptoms of a menstrual period. Bleeding and spotting can last several days (up to a few weeks) following a medication abortion.

Seven to 14 days after taking the second drug (misoprostol), it is important for patients to come back to the clinic for a follow-up. We will confirm that the abortion is complete using an ultrasound, and can start a method of birth control at this time.

The medication taken during a medical abortion can cause birth defects if the pregnancy does not terminate successfully, which occurs in less than 5 percent of patients. For this reason, we strongly recommend surgical abortions if the medical abortion is unsuccessful.

Surgical abortion

Early surgical abortions terminate pregnancy during the first trimester. Surgical abortions, unlike medication abortions, can be performed up to 22 weeks in our clinic. However, surgical abortions performed 12 weeks or earlier (first trimester) are less expensive and have a lower risk of complications than later surgical abortions.

First trimester surgical abortions are performed in the clinic with local anesthesia and optional oral or intravenous pain-relieving medication. During the procedure, a speculum is inserted into the vagina, the cervix (the opening to the uterus) is slightly stretched open, and a small tube is inserted to remove the pregnancy using a suction (or vacuum). The procedure usually only takes 5-10 minutes.

During the surgical abortion and for a short time after, patients may experience strong cramping. Bleeding and spotting often occurs for a few days or weeks following the procedure as well.

After a surgical abortion, our health educators provide instructions on how a patient should take care of their body following the procedure. The doctor will also prescribe antibiotics and birth control, if desired.

Follow-up procedures are not required after a surgical abortion unless complications related to the abortion begin to occur. We do recommend that patients make an appointment to see a regular physician for an annual Pap smear, physical/gynecologic exam and birth control refill requests.

The Comprehensive Women’s Health Center difference

We are dedicated to providing expert, affordable pregnancy termination. We believe every patient deserves to be treated with respect and dignity regardless of any life circumstances.

Our clinic was founded with three major goals:

  • To provide accessible, high-quality abortion and family planning services in a private, comfortable and sensitive atmosphere.
  • To expand access to abortion services by training future providers.
  • To improve contraception and abortion services through clinical research.

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