Svetlana Radeva
Medical University of Varna - Faculty of Public Health
Specialized hospital of obstetrics and gynecology for active treatment – Varna, Bulgaria
DOI : https://doi.org/10.47191/ijmra/v7-i01-22Google Scholar Download Pdf
ABSTRACT:
Review of the current literature on pain prevention in induced abortion.An in - depth analysis of the guidelines of leading international and national organizations
for prophylaxis of induced abortion-surgical and medicated abortion during the I-st and II-nd trimester in terms of pain response has been carried out. Shared with the
author's many years of practical experience in order to assess the risks and benefits of the application of modern means of prophylaxis in artificial abortion and thus
to improve the individual obstetric-gynecological practice.
Methods: review of available literature from the last 10 years.
Results and discussion:Paracetamol, oral lorazepam and nitric oxide do not improve pain control. Currently, the use of sedation is not recommended for Surgical abortion.
Inhalation anaesthesia should not be used for sedation. Intravenous sedation with fentanyl and midazolam is recommended and safe - below 1.0% complications.
In Medical abortion, 75.0% of women experience pain severe enough to require analgesia. The pain begins 2.5 to 4 hours after the use of perplex and
lasts about an hour. During the extravehicular trimester, taking a higher number of doses intravenously is associated with more severe and frequent pain.
In medicated abortion < 14 gw. non-steroidal anti-inflammatory drugs are recommended 30-45 minutes before the procedure. Non-steroidal medicines do not reduce
the efficacy of urgencies. Routine administration of paracervical block before 13 gw. when using modern means for medicated abortion is unnecessary. Narcotic
analgesics (Tramadol) do not affect pain in early Medical abortion and their routine use is not recommended.
Conclusion:In Surgical abortion, analgesia is always offered. Most commonly, analgesics, such as non-steroidal anti-inflammatory drugs local anesthesia
(paracervical block with Lidocaine 20.1%; or 10.2%),) and/ or sedation, supplemented with verbal sedation, are sufficient to relieve pain before mechanical
cervical dilation and during uterine evacuation. The technique of deep paracervical injection of Lidocacaine at two points is recommended.
induced abortion, prophylactic, pregnancy
REFERENCES1) Deroche N.L., Constant D., The costs and cost effectiveness of providing second-trimester medical and surgical safe abortion services in Western Cape Province, South Africa, PLOS ONE | https://doi.org/10.1371/journal.pone.0197485 June 28, 2018.
2) Edelman, A. & Kapp, N. (2018). Dilatation & Evacuation (D&E) Reference Guide: Induced abortion and postabortion care at or after 13 weeks gestation (‘second trimester’). Chapel Hill, NC: Ipas.
3) Ipas. (2021). Clinical Updates in Reproductive Health. N. Kapp (Ed.). Chapel Hill, NC: Ipas.
4) Meaidi A., Heimustovua B.H. et all. Declining risk of surgical intervention following early medical abortion: A time trend analysis, Contraception 104 (2021) 492–495.
5) National Abortion Federation (NAF). Clinical Policy Guidelines for Abortion Care 2018.
6) Queensland Clinical Guidelines, Health professionals in Queensland public and private maternity and neonatal services. VTE prophylaxis in pregnancy and the puerperium March 2020.
7) World Health Organization. 2022, Abortion care guideline, ISBN 978-92-4-003948-3 (electronic version) (405). 2022, WHO.
8) Zhekov Zh., Kovachev E., Tabakova N. 2020. Medical abortion or vacuum aspiration for pregnancy interruption in first trimester. Akusherstvo i gynekologia, Sofia (2020):13-16.
9) Zhekov Zh. 2021. Methods of termination of pregnancy in obstetric-gynecological practice. Thesis for the award of educational and scientific degree "Doctor“.
Volume 07 Issue 01 January 2024
There is an Open Access article, distributed under the term of the Creative Commons Attribution – Non Commercial 4.0 International (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/), which permits remixing, adapting and building upon the work for non-commercial use, provided the original work is properly cited.
Our Services and Policies
Authors should prepare their manuscripts according to the instructions given in the authors' guidelines. Manuscripts which do not conform to the format and style of the Journal may be returned to the authors for revision or rejected.
The Journal reserves the right to make any further formal changes and language corrections necessary in a manuscript accepted for publication so that it conforms to the formatting requirements of the Journal.
International Journal of Multidisciplinary Research and Analysis will publish 12 monthly online issues per year,IJMRA publishes articles as soon as the final copy-edited version is approved. IJMRA publishes articles and review papers of all subjects area.
Open access is a mechanism by which research outputs are distributed online, Hybrid open access journals, contain a mixture of open access articles and closed access articles.
International Journal of Multidisciplinary Research and Analysis initiate a call for research paper for Volume 07 Issue 11 (November 2024).
PUBLICATION DATES:
1) Last Date of Submission : 26 November 2024 .
2) Article published within a week.
3) Submit Article : editor@ijmra.in or Online
Why with us
1 : IJMRA only accepts original and high quality research and technical papers.
2 : Paper will publish immediately in current issue after registration.
3 : Authors can download their full papers at any time with digital certificate.
The Editors reserve the right to reject papers without sending them out for review.
Authors should prepare their manuscripts according to the instructions given in the authors' guidelines. Manuscripts which do not conform to the format and style of the Journal may be returned to the authors for revision or rejected. The Journal reserves the right to make any further formal changes and language corrections necessary in a manuscript accepted for publication so that it conforms to the formatting requirements of the Journal.