Saturday, 6 February 2021

Unwanted pregnancy - a growing concern




 Nowadays the incidence of unwanted pregnancies is increasing, especially in unmarried women because lack of awareness of menstrual cycle, ovulation and other preventive measures of pregnancy.

Avoiding unprotected intercourse around the time of ovulation can decrease the incidence of unwanted pregnancies. In case of regular 28 to 30 days menstrual cycles, ovulation is expected between 13th to 18th day. In case of irregular menstrual cycles, it is a little bit difficult to predict the time of ovulation but ovulation kits and cervical mucus method can help to some extent.

If a woman misses her expected date of periods,even though if she had irregular periods previously, better to check for pregnancy once when there is possibility.

Pregnancy can be diagnosed around the period of the expected date by blood test for pregnancy within one week after missing the period by urine pregnancy test.

If the woman recognises that she is pregnant, and she doesn't want to continue the pregnancy better to consult a gynecologist as early as possible and have to undergo an ultrasound once.

Ultrasound helps in confirming the intrauterine pregnancy, gestational age,  and in excluding the ectopic pregnancy.

Once the gestation is confirmed if the woman and her partner do not want to continue the pregnancy, they can go for medical termination of pregnancy by tablets upto 8 weeks of pregnancy.

After 8 weeks till 10 weeks medical termination can be tried, but there is very much possibility for retained products of conception, which may need dilation and evacuation.

Usually around 11 to 12 weeks along with tablets dilation and curettage should be done.

After 12 weeks as the bones starts developing in the baby dilatation and evacuation becomes a little difficult that may harm the uterus.In that case abortion should be induced like mini labour.

Gestational age between 14 to 18 weeks, usually not respond well for the induction that may lead to prolonged induction and sometimes hysterotomies also. Whereas gestational age above 18 weeks usually respond well for induction.

Recognising the pregnancy early and consulting the gynecologist as early as possible are key factors in avoiding unnecessary surgical interventions, physical and mental strain to the patients in case of unwanted pregnancies.

If at all termination is needed better to terminate before the heartbeat of the baby develops, which will be possibly the best thing.

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