Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines
CPT4 code
Name of the Procedure:
Induced Abortion by Intra-Amniotic Injections (Amniocentesis-Injections)
Summary
This procedure involves inducing an abortion through one or more injections into the amniotic sac. It includes hospital admission, observation visits, and the delivery of the fetus and secundines (placenta and membranes).
Purpose
This procedure is performed to terminate a pregnancy. It may be necessary due to medical conditions impacting the health of the mother or fetus, or personal choice.
Indications
- Severe fetal abnormalities
- Maternal health risks that are exacerbated by pregnancy
- Failed medical abortion
- Genetic disorders diagnosed in utero
- Personal or socio-economic reasons
Preparation
- Fasting for at least 8 hours before the procedure
- Discontinuation or adjustment of certain medications as advised by your doctor
- Pre-procedure blood tests to check clotting times and overall health
- Ultrasound to assess fetal position and amniotic fluid volume
Procedure Description
- Hospital Admission: The patient is admitted and provided an overview of the procedure and its steps.
- Anesthesia: Local anesthesia may be applied to numb the area where the needle will be inserted.
- Amniocentesis: A needle is inserted through the abdominal wall into the amniotic sac under ultrasound guidance.
- Injection: The first of one or more injections is administered directly into the amniotic sac to terminate the pregnancy.
- Monitoring: The patient is monitored for reactions or complications following the injection.
- Delivery of Fetus and Secundines: The procedure includes the delivery of the fetus and secundines after the induced abortion. This may occur naturally or may require medical assistance.
Duration
The procedure itself takes about 30 to 60 minutes. The induction and delivery process may take several hours to a few days.
Setting
The procedure is conducted in a hospital setting due to the need for close monitoring and potential need for emergency care.
Personnel
- Obstetrician/Gynecologist (OB/GYN)
- Anesthesiologist (if general anesthesia is needed)
- Nursing staff
- Ultrasound technician
Risks and Complications
- Infection
- Excessive bleeding
- Injury to nearby organs
- Emotional and psychological effects
- Uterine perforation
- Reaction to anesthesia
Benefits
- Safe termination of pregnancy under medical supervision
- Reduced risk of complications for certain maternal or fetal health conditions
- Comprehensive hospital care ensures immediate management of any complications
Recovery
- Hospital stay for observation typically lasts 1-2 days.
- Post-procedure care includes pain management, monitoring for excessive bleeding, and infection prevention.
- Follow-up appointments are necessary to ensure full recovery and address any complications.
- Most patients can resume normal activities within a week but should avoid strenuous activity for several weeks.
Alternatives
- Medical abortion with pills
- Surgical abortion (Dilation and Curettage - D&C)
- Expectant management (waiting for natural miscarriage)
- Continuation of pregnancy
Each alternative has its pros and cons, including varying risk levels and emotional impacts.
Patient Experience
- The patient may feel anxious and emotional before, during, and after the procedure.
- Discomfort or pain at the injection site and during the delivery process.
- Pain management through medication will be provided.
- Emotional support and counseling are recommended to help cope with the psychological impact.