2023-07-14 08:56:58
Didn’t bring all the baby’s luggage?4 common situations in which pregnancy has to be terminated, and the method of induction is determined according to the number of weeks
Text／Tiffany Interview／Shao Zhixuan, Attending Physician of Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital
It is the wish of every pregnant mother to get pregnant and give birth smoothly. However, sometimes in certain situations, the pregnancy has to be terminated, miscarried or induced.
Under what circumstances must the fetus be abandoned in advance? How to adjust the psychology of pregnant mothers? Since there are many clinical cases, it is worth knowing.
There are two main options for terminating a pregnancy: induced labor and induced labor. Shao Zhixuan, an attending physician at the Department of Obstetrics and Gynecology at Tzu Chi Hospital in Taipei, explained that birth induction and labor induction refer to the difference in the way the fetus is delivered. Physicians will use birth-inducing drips or suppositories to speed up the labor process; while labor induction may occur at any stage of pregnancy, and labor signs have not yet appeared, but due to fetal or maternal conditions, the pregnancy must be terminated. Doctors must artificially induce labor signs, and then deliver the fetus.”
Didn’t bring all the baby’s luggage?4 common situations in which pregnancy has to be terminated, and the method of induction is determined according to the number of weeks
Common reasons for pregnancy termination
According to the Regulations for the Implementation of the Eugenics and Health Care Law, legal induced abortion can be performed within 24 weeks of pregnancy. If the pregnancy is less than 12 weeks, it must be performed in a medical institution with a doctor who performs induced abortion; if it exceeds 12 weeks, it should be performed in a medical institution. Hospitalization by doctors who perform induced abortions.
Once the pregnancy exceeds 24 weeks, induced abortion cannot be performed according to the wishes of the pregnant woman, unless there are major abnormalities or diseases in the fetus or mother.
Dr. Shao Zhixuan mentioned that the common reasons for termination of pregnancy can be divided into the following 4 situations:
1. Fetal growth is not as expected
Whether it is the problem of the fetus itself or the unfavorable environment of the uterus, such as: uterine infection, poor placental function, etc., following evaluation, the doctor will advise the pregnant woman to terminate the pregnancy and induce labor early if she needs to rely on external medical help.
2. Maternal condition is not good
Pregnant women suffer from genetic diseases, or are receiving a large amount of radioactive or chemical drug treatment, or other diseases such as preeclampsia in the middle and late stages of pregnancy, resulting in abnormal liver and kidney function, heart and lung function, etc., doctors will advise Let the fetus leave the mother’s body as soon as possible to ensure the safety of the mother and fetus.
Didn’t bring all the baby’s luggage?4 common situations in which pregnancy has to be terminated, and the method of induction is determined according to the number of weeks
3. The fetus suffers from a major defect or disease
After prenatal examination, it is found that the fetus suffers from chromosomal gene abnormalities (such as Down syndrome, Edwards syndrome and Patau syndrome), congenital metabolic abnormalities, or severe deformities. Early induction of labor is recommended.
4. Stillborn
If the stillbirth stays in the mother’s body for too long, it will affect the abnormal blood coagulation function of the pregnant woman and cause complications. Once the fetus is found to have no heartbeat following examination, labor will be induced.
Methods of labor induction at different weeks
When pregnant mothers must terminate pregnancy early, there will be different ways to proceed according to the number of weeks of pregnancy. Dr. Shao Zhixuan said that for pregnancies seven to eight weeks ago, doctors will use drugs or vaginal suppositories for spontaneous abortion. After taking the drug, it will also bring some side effects to pregnant women, such as abdominal pain, nausea and vomiting.”
When the pregnancy week reaches regarding 14 weeks (within), the effect of using medical abortion is limited, and some tissue may remain. At this time, the doctor will recommend surgical abortion. Dr. Shao Zhixuan said that pregnant women will need to receive intravenous anesthetics, and surgical methods Compared with medical abortion, artificial abortion may cause more bleeding, which will cause greater harm to the mother’s body.
As for induction of labor over 14 weeks, Dr. Shao Zhixuan pointed out that “it is actually like simulating childbirth.” Pregnant women must be hospitalized, and doctors will administer oxytocin drips to strengthen uterine contractions, or give cervical softeners or other prostaglandin drugs , Accelerate the softening of the cervix, so that pregnant women can deliver the fetus.
“Most women will give birth naturally, but if there are special circumstances, such as placenta previa, abnormal fetal position, uterine surgery in the past, delayed labor, fetus less than 1,500 grams, etc., during the process of uterine contraction, there may be some worries. If there is a possibility of uterine rupture, cesarean delivery will be adopted. “It is recommended to discuss with the doctor and choose the delivery method that suits you.”
※The original article was published in the July 2023 issue of “Mom and Baby” Issue 437.
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