Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation
CPT4 code
Name of the Procedure:
Induced Abortion with Vaginal Suppositories and Dilation and Curettage (D&C)
Summary
Induced abortion is a medical procedure that terminates a pregnancy. It involves the insertion of vaginal suppositories, often prostaglandin, to induce labor, along with or without the use of cervical dilation techniques like laminaria. The procedure includes hospital admission, visits, delivery of the fetus and placenta, followed by dilation and curettage (D&C) or evacuation of the uterine contents.
Purpose
This procedure addresses the medical or personal need to terminate a pregnancy. The goals are to safely remove the fetus and placental tissue, alleviate any associated medical conditions, and reduce the physical and emotional burden on the patient.
Indications
- Unplanned or unwanted pregnancy
- Medical complications necessitating termination (e.g., severe fetal anomalies, risk to the mother's health)
- Patient's personal or social reasons
- Fetal demise within the uterus
Preparation
- Follow instructions regarding fasting if anesthesia is planned.
- Discuss all current medications with the healthcare provider; some adjustments may be necessary.
- Undergo necessary diagnostic tests like ultrasound or blood tests to confirm pregnancy and assess health.
Procedure Description
- Hospital Admission: Patient is admitted to the hospital or surgical center.
- Vaginal Suppositories: Prostaglandin suppositories are inserted into the vagina to induce labor and soften the cervix.
- Cervical Dilation: Laminaria or other mechanical dilators may be used to gently open the cervix.
- Delivery: Labor results in the delivery of the fetus and placenta.
- Dilation and Curettage: A D&C is performed to ensure complete evacuation of uterine contents.
- Sedation/Anesthesia: Local or general anesthesia may be provided to ensure patient comfort.
Duration
The entire process typically takes several hours, from the insertion of suppositories to the completion of D&C. Hospital stays may vary from a few hours to overnight.
Setting
Usually performed in a hospital or specialized outpatient surgical center.
Personnel
- Obstetrician/Gynecologist (OB/GYN) or trained abortion provider
- Nurses
- Anesthesiologist (if general anesthesia is used)
- Support staff
Risks and Complications
- Common: Cramping, bleeding, infection
- Rare: Perforation of the uterus, incomplete abortion, severe hemorrhage, reactions to anesthesia
- Management: Immediate medical attention, blood transfusions, further surgical interventions if needed
Benefits
- Safe and effective termination of pregnancy
- Alleviates medical complications associated with the pregnancy
- Psychosocial relief for the patient
Recovery
- Monitor bleeding and cramping; both should subside in a few days.
- Follow-up appointments to ensure complete recovery.
- Avoid strenuous activities and sexual intercourse for a few weeks.
Alternatives
- Medical abortion with oral medications (e.g., mifepristone and misoprostol)
- Surgical abortion by suction aspiration (manual or electric)
- Continuation of the pregnancy
Each alternative has its own pros and cons, which should be discussed with a healthcare provider to determine the best option based on gestational age and individual health circumstances.
Patient Experience
- During the Procedure: May experience cramping similar to menstrual pain. Anesthesia or sedation can alleviate discomfort.
- After the Procedure: Cramping, light bleeding, and emotional responses are common. Pain management includes prescribed pain relievers and comfort measures like heating pads.
Always consult with your healthcare provider for personalized advice and information.