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11 weeks pregnant and planning for abortion. What are the future complications?

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Dr. Asra Ishtiaq Ahmed

OBGYN

Practicing since :2008

Answered : 689 Questions

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Posted on Tue, 11 Dec 2012 in Women's Health
Question: hi,
i'm in a very bad state.
i'm currently 11.5 weeks pregnant and am scheduled for an abortion this week.
i can't go past 12 weeks in my area.
i'm very afraid of the abortion procedure. it's vacuum aspiration (electric).
here are my fears:
-I'm worred the abortion will affect my future fertility. I am worried it will cause asherman's or scarring (I read that even vacuum type can cause this). I'm worried it will cause pelvic inflammatory disease. I don't think I have an STI like chlamydia, but there's always a risk and i haven't been tested since being with my new boyfriend.
-I'm worried it will weaken my cervix beyond repair and that i'll continue to have miscarriages/preterm births in the future.


Another thing is that my FSH is getting high for my age (12) and so this has been a heartbreaking decision for me. I'm only 31 and DO want to have another child. I have a toddler already. she was conceived easily and i had her on my own.

The man i'm currently with is not nice to me and my baby and i feel like i have no choice to do this. i really want one more baby in the future with someone i love but am worried the abortion will kill my dreams.
Please help? Will I be infertile after?
doctor
Answered by Dr. Asra Ishtiaq Ahmed 53 minutes later
Hello there.

Thanks for writing.

I understand your anxiety in this matter.

I wish to know the reason for you going for abortion. Is it because you do not like the father of this baby or is it because of a medical reason?

It is always better to complete your family as early as possible because fertility of a woman decreases with age and gynecological problems can arise.

Infertility can occur after any abortion procedure though the risk is not absolute.

Vacuum aspiration has lesser chances than other surgical procedures like curettage.

However medical abortion has the least risk of future infertility provided it is not followed by a surgical procedure due to incomplete abortion.

Your pregnancy being 11 weeks increases the chances of a medical abortion to fail in your case.

Cervical insufficiency can result if forced or excess dilatation is done during a vacuum procedure. This can be avoided by taking a prostaglandin medication prior to abortion procedure which will ripen and dilate your cervix to some extent avoiding the need to dilate it with instruments. You can discuss with your doctor regarding using them.

Pelvic inflammatory diseases are also a complication of abortion procedure if proper aseptic precautions and antibiotics are not used during the procedure.

Both ashermann's and PID are rare complications.
Every procedure has its pros and cons so you have to bear in mind before going for any as some complications are unavoidable.
If you have a predisposition to scarring or infections,even if all precautions are taken you might get them.

FSH levels are normally between 3-10 IU/l. Your level being 12 is a bit worrisome if your test was not done in the midcycle(ovulation) time or when you were already pregnant. This is because during these times levels are higher can be upto 17 IU/l.

I hope I have answered your queries.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Asra Ishtiaq Ahmed 11 minutes later
thanks for the reply. i am ending the pregnancy because i do not like the father...he is rather threatening. i am sad to end this.

will my uterus go back to it's normal size if i'm not breastfeeding? it's already a bit large.
doctor
Answered by Dr. Asra Ishtiaq Ahmed 26 minutes later
Hello there.

Thanks for writing back.

Sorry for you. I hope that all ends well with you.

Yes, your uterus will revert back to normal size after abortion.
The uterus contracts back to its normal size after abortion generally over two weeks when you may have cramping or slight pain in the abdomen.

To ensure proper recovery after abortion, you should complete your course of antibiotics.
Avoid swimming, heavy exercise and sexual activity for atleast 2 weeks.
Take good rest and proper diet.


Wishing you All the Best,

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Asra Ishtiaq Ahmed 2 days later
I have one more question after discussing with my doctor.

I am scheduled to have the abortion next Friday now because I need an ultrasound first. If I am more than 12 weeks, 6 days, they will have to use laminaria. If not, they will use misoprostol medicine to dialate cervix, plus maybe mechanical.

Will either of these processes lead to cervical insufficiency in future pregnancies? I really want another baby, but not with the man I am with because he is controlling.

We are still doing vacuum abortion.
doctor
Answered by Dr. Asra Ishtiaq Ahmed 36 minutes later
Hello there.

Thanks for writing back.

Your doctor's decision is wise enough to do an ultrasound prior to the abortion. This is necessary as it helps in knowing the site and size of pregnancy based on which termination procedure is chosen.

Neither laminaria nor misoprostol use prior to the vacuum abortion cause cervical insufficiency.
Both of these will in fact prevent cervical insufficiency by avoiding the need of forced dilatation during the vacuum evacuation.

This is because both of these (laminaria and misoprostol) are methods to ripen the cervix that is make it favorable and soft thereby making the dilatation easy to insert the suction tube for vacuum aspiration. Also they dilate the cervix to some extent thereby at times avoiding the need of mechanical dilatation with instruments during surgical (vacuum) evacuation.

Thus you need not worry about them making your cervix incompetent for future pregnancies.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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