1. Medical examinations before surgical abortion
Moscow Regional Research Institute of Obstetrics & Gynecology
Olga Serova, MD, professor

2. Abortions and deliveries in Moscow Region
Girls up to 14 years
2002г. – 0,11%;
2003г. – 0,08%.

3. Modern Technologies of Induced Abortion
Surgical abortion
Vacuum aspiration (mini-abortion)
Medical methods (mifepristone)

4. Early abortion complication
Cervical trauma
Incomplete abortion / Failed abortion
Haemorrhage
Uterine perforation

5. Maternal mortality in Moscow Region

6. Abortion Complication
14%
12%
10% 8% 6% 4% 2% 2% 0%
Haemorrhage
Endometritis
Incomplete abortion

7. Risk Factors in developing of abortion complications
Chronical inflammatory diseases
STI
Scar utery
Leomyoma uterus
Frequent changes sex partners
Operations in women’ hystory

8. Rehabilitation after abortion
Before abortion
During abortion
In early post-abortion period
Long-term period

9. Pre-abortion care Confirming the pregnancy
Physical examination and pre-existing conditions
Information and counseling

10. Physical examination before abortion
Ultrasound scanning
Measuring haemoglobin and haematocrit (Нв, Ht)
Tests for ABO and Rhesus (Rh) blood group typing
Tests for RW, HIV, HbsAg, HCV
Laboratory testing for RTIs
Cervix Cytology
Others – in special indications

11. Ultrasound scanning Confirm pregnancy and estimate its duration
Detection of ectopic pregnancy
Pre-existing conditions (leiomyoma uterus, abnormalities etc)
Intrauterine device

12. Blood Laboratory Testing
Measuring hemoglobin and haematocrit – to detect anemia and blood diseases
Tests for ABO and Rhesus (Rh) blood group typing – for anti-D immunoglobulin injection
Tests for RW, HIV, HBsAg, HCV – for prevention abortion complication

13. For excluding RTI Bacterioscopy is not enough information
RTI – for inflammatory diseases diagnostic’s

14. Rehabilitation during abortion
Methods of abortion
Abortion clinics or facilities
Pain management
Emergency treatment

15. Rehabilitation in post-abortion period
After medical abortion – 2 hours observation, ultrasound – in 7-10 days
After surgical abortion - observation in a hospital, physical examination and ultrasound before discharge

16. Inflammatory Diseases Prevention
Medical abortion
Vacuum aspiration
Surgical abortion
Chomical inflammatory
diseases
Uterus’ scar
Repeated operative
treatment in women’s life
Pre-existing STI
Colpitis
Bacterial vaginosis
In any cases

17. Inflammatory Diseases Prevention
After medical abortion – Cefuroxim 150 mg (one dose)
During vacuum aspiration - Cefuroxim 150 mg (one dose)
After surgical abortion – antibiotics prevention courses
during 5-10 days

18. Effectiveness prevention' programs after abortion (1 year follow-up)