In the case of an unwanted pregnancy, the woman decided to have an abortion, it is better not to delay. Medical abortion can only be done in early pregnancy - up to nine weeks.

Operating principle

Mifepristone is taken in combination with misoprostol. First, the doctor gives the patient a tablet of mifepristone, and she immediately takes it. Mifepristone causes the placenta to separate from the endometrium - mucous membrane of the inside of the walls of the uterus. It also softens the cervix and cause uterine contractions.

Within 48 hours after mifepristone patient should take misoprostol. More specifically, about the time of admission in each case, the doctor said. Misoprostol causes contractions resulting in the expulsion of the fetus. Some clinics offer patients remain under medical supervision for four hours after taking misoprostol - if any serious side effects appear, usually at this time. However, many patients taking misoprostol alone at home. Pregnancy usually ends after four to six hours after taking the second drug.

For medical abortion Medical abortion - be wary of the ordinary   was normal, you need a minimum of two visits to the doctor (if you count the first in which the pregnancy is confirmed, - three). During the first visit, the doctor gives the patient mifepristone and misoprostol, which she takes with him and take home. Then, two weeks later the patient was examined by ultrasound to confirm that the pregnancy is over, and there were no complications. If medical abortion is not successful (that happens, but very rarely), it is necessary to do a surgical abortion. If you do not terminate a pregnancy after a failed medical abortion, the impact of misoprostol will cause serious abnormalities in the fetus.

Effectiveness

The effectiveness of the use of mifepristone and misoprostol to the seventh week of pregnancy up to 92%. With increasing gestational age reduces the effectiveness of drugs abortnyh.

Within four hours after administration of the second tablet in women usually begins bleeding and contractions, which means the end of pregnancy. If not, take a second tablet of misoprostol.

Tablets of misoprostol are both oral and vaginal. Vaginal considered somewhat more efficient, but they have more side effects. However, most doctors prescribe oral tablets, as it is known on the unit when receiving vaginal misoprostol caused fatal infection in patients.

Side effects

After receiving mifepristone and misoprostol following symptoms may occur:

• Sickness
• Vomiting
• Diarrhea
• Headache
• Chills and hot flushes
• Tremors
• Weakness

Symptoms can appear the stronger, the more was the duration of pregnancy, as well as if it was a woman's first pregnancy. Such symptoms can have very dangerous infections, so the appearance of these symptoms contact your doctor immediately.

Signs of complications

Serious and dangerous complications after medical abortion are less than 1% of women. If the following symptoms should immediately call your doctor:

• Heavy bleeding (clots are large, you need more than two pads per hour, heavy bleeding lasts more than 12 hours)
• Signs of infection such as headache, muscle aches, dizziness, severe deterioration of health in general,
• Acute pain in the lower abdomen
• Temperature increase
• Vomiting for four to six hours
• Rapid pulse
• Heavy vaginal discharge with a bad odor
• Pain or redness in the genital area

If the bleeding does not take place within two weeks after the abortion, if, within six weeks after the abortion will not begin menstruating or if there are signs of depression, we will need to register for a doctor.

Medical abortion is not recommended if the patient has something of the following:

• Suspected ectopic pregnancy
• Intrauterine device
• Long-term use of corticosteroids
• Adrenal insufficiency
• Severe anemia
• Problems with blood clotting, and the use of drugs against blood clotting (anticoagulants)
• Asthma
• Liver and kidney disease
• Heart disease and hypertension
• Respiratory system diseases
• Allergy to mifepristone
• Hereditary skin diseases

Immediately before and after administration of mifepristone and misoprostol not take aspirin and drink alcohol.

After medical abortion

One of the consequences of medical abortion may be severe emotional reaction. When pregnancy occurs, the body begins to produce hormones that contribute to normal development of the fetus; after abortion need for them disappears hormone level changes abruptly, and that may cause depression. You should seek medical advice if for more than two weeks of symptoms of depression persist Depression - a little more than a bad mood Such as: drowsiness or insomnia, depression, a sense of emptiness, anxiety Anxiety - how to distinguish normal from disease?   and irritability Irritability - you try to control my temper .

In the first week after the abortion is strongly recommended to have sex. And when the body recovers, we must bear in mind that a new pregnancy may occur very soon, so it is better not delay, start taking birth control.

The contraceptive patch - an easy-to-use hormonal medication to prevent pregnancy prolonged action is as effective as the same drugs for oral administration. This more advanced and convenient dosage form which, nevertheless, has the same contraindications and side effects, and oral contraceptives.

The mechanism of action Evra contraceptive patch

Evra is a patch that is attached to the skin (transdermal patch or transdermal therapeutic system - TTS) and has all the properties of hormonal contraceptives.

Evra produces a group of pharmaceutical companies Janssen, one Evra patch contains 6 mg norelgestromina and 0.75 mg of ethinyl estradiol. After attaching the patch to the skin daily for a week allocates 150 ug norelgestromina (synthetic progesterone analogue) and 20 mcg of ethinyl estradiol (estrogen synthetic analog).

The mechanism of action Evra associated with suppression of synthesis and secretion of pituitary hormones. And since these hormones to stimulate egg maturation and ovulation suppression of their isolation prevents conception.

Terms of use

Evra is used for contraception prescribed by a doctor after a preliminary examination, women and exclude contraindications for its use.

Evra patch attached to the skin of the buttocks, abdomen or shoulder on the first day of the menstrual cycle The days of the menstrual cycle: Four phases   (first day of menstruation). Adhesive holds well on the skin and does not come unstuck at a water procedures. Exactly a week (8th day of the menstrual cycle, which falls on the same day of the week) and unstick the patch is replaced. On the 15th day of the patch changes again and carry it to the 22-day menstrual cycle and then take off. From 22 th to the 28 th day of the menstrual cycle, the patch is not glued - at this time begins menstrualnopodobnoe bleeding. New plaster should be stuck the next day after the end chetverntaya week. Plaster paste even if the menstruation is not over.

Evra patch requires careful observance of the rules of application - depends on its effectiveness.

In which case Evra contraceptive patch is contraindicated

Evra contraceptive patch is not less contraindications and side effects than oral contraceptives (hormone pills). Application Evra is contraindicated:

• venous insufficiency complicated by thrombosis and embolism, even if these complications were a woman in the past;
• arterial thrombosis, including coronary with the consequence of a myocardial infarction, cerebral with the outcome in the form of an ischemic stroke, retinal artery and so on; in diseases of the arteries, which can lead to thrombosis and thromboembolism (eg, angina, stable high blood pressure (BP), diabetes mellitus);
• in hereditary disorders of lipid metabolism, hereditary weakness of the walls of veins and arteries, predisposition to thrombosis (eg, elevated blood clotting);
• migraine, in which before the attack, a woman has a special feeling, harbingers of attack (aura); such attacks are accompanied by a sharp spasm of first (during the aura), and then a sharp expansion of blood vessels and blood stagnation tendency to form blood clots;
• breast cancer, uterine cancer or suspected of these diseases;
• for tumors of the liver;
• uterine bleeding;
• at the age of 18 and after menopause;
• In the first month after birth;
• Pregnancy and breast- Breastfeeding - a personal choice   breast;
• if you are hypersensitive to the components of the drug;
• It can not be attached to patch damaged or inflamed skin, as well as on the skin of the breast.

Precautions Evra contraceptive patch is used in obesity, varicose veins, diabetes, heart disease, high blood pressure, systemic connective tissue diseases, ulcerative lesions of the stomach and intestines, liver problems and kidney, menstrual irregularities.

Side effects

All hormonal contraceptives have side effects and the patch Evra is no exception:

• nervous system - dizziness, headache (including migraine in the form), sensory disturbances, trembling of the hands and feet of the entire body, convulsive readiness, mood swings, anxiety Anxiety - how to distinguish normal from disease? Sleep disorders;
• heart and blood vessels - an increase or decrease in blood pressure, swelling, venous insufficiency (varicose veins and hemorrhoids), thrombosis and embolism;
• digestive system - eating disorders, inflammation of the gums, the walls of the stomach or bowel, vomiting, diarrhea or constipation, abdominal pain Abdominal pain: Types and Symptoms , Abnormal liver function;
• bronchopulmonary system - inflammation of the upper respiratory tract, bronchial asthma;
• urogenital system - pain during sexual intercourse, menstrual disorders, inflammation, disorders of breast and ovarian cancers, benign tumors, cysts, cancer of the cervix; inflammation of the kidneys and urinary tract;
• skin - allergic (including allergic to light exposure) and acne, alopecia, sweating;
• eye - blurred vision, inflammation;
• metabolism - weight gain, lipid metabolism disorders;
• flu-like symptoms.

Evra contraceptive patch is applied only on prescription, and after the test.

Galina Romanenko