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MoonDragon's ObGyn Womens Health Information
ABORTION
HYSTEROTOMY


For "Informational Use Only".
For more detailed information, contact your health care provider
about options that may be available for your specific situation.




BASIC INFORMATION


DESCRIPTION

A hysterotomy is an incision in the uterus, commonly combined with a laparotomy during a cesarean section. Hysterotomies are also performed during fetal surgery.

HYSTEROTOMY ABORTION

The hysterotomy is a technique of electively terminating a pregnancy. In this method, a surgical procedure similar to a cesarean section is performed with all the same risks and complications associated with a cesarean delivery. It is reserved for special circumstances, such as when other abortion methods have failed, and usually is not the primary abortion method chosen. The fetus in this photo is being lifted by one foot and the umbilical cord is being clamped and cut.

hysterotomy abortion


The fetus is usually killed prior to or at the time of the delivery, usually by cutting the umbilical cord to prevent the fetus from getting oxygen. Occasionally a fetus will survive and may have to be killed after delivery by the health care provider or allowed to die on it's own through neglect. Many countries have laws in place to cover any fetus that is born during an abortion and survives the procedure, but cases have been documented of such babies being left to die. Occasionally when a fetus survives, the mother will choose to keep it or have it adopted out.

This information and instruction is based on the assumption that you have had, or will have, counseling and competent guidance in making your decision to seek this procedure for termination of the pregnancy.






REASONS FOR PROCEDURE

  • Personal concerns about the social or economic aspects that involve an unplanned pregnancy.


  • Continuing with the pregnancy may pose a threat to the life of the mother.


  • Mother has a genetic condition which the fetus is at significant risk of acquiring, or the fetus has been tested and is known to have the condition (such as cystic fibrosis).


  • Pregnancy resulted from a rape.


  • Fetus is affected with a major disorder such as chromosomal abnormality or birth defect.


  • Fear that the fetus has been harmed by medications or other conditions.





  • RISK INCREASES WITH

  • Obesity.


  • Smoking.


  • Poor nutrition.


  • Recent or chronic illness.


  • Use of drugs such as anti-hypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; narcotics; beta-adrenergic blockers; or cortisone.


  • Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedative; hypnotics; or cocaine.





  • DESCRIPTION OF PROCEDURE

  • A general anesthesia is used.


  • An incision is made in the abdomen and then in the uterus. Fetal tissue and placenta are removed.


  • The uterus wall is sewed back together and the abdominal opening closed.




  • HYSTEROTOMY ABORTION

    Hysterotomy abortion is a form of abortion in which the uterus is opened through an abdominal incision and the fetus is removed, similar to a cesarean section, but requiring a smaller incision.[1] As major abdominal surgery, hysterotomy is performed under general anesthesia, and is only used in rare situations where less invasive procedures have failed or are medically inadvisable (such as in the case of placenta accreta).[2] It is used between the 12th and 24th week of pregnancy.[2]

    This method has the greatest risk of complications out of all the abortion procedures.[2] Health officials in the United States warned practitioners against performing hysterotomy abortion in an outpatient setting after it led to the deaths of two women in New York during 1971.[3][4] The rate of mortality for abortion by hysterotomy and hysterectomy reported in the United States between 1972 to 1981 was 60 per 100,000, or 0.0006%.[5]

    REFERENCES

    1. Abortion. (2007). MSN Encarta. Retrieved July 1, 2007.

    2. a b c Roche, Natalie E. (June 16, 2006). Surgical Management of Abortion. Retrieved July 1, 2007.

    3. Berger, G.S., Tietze, C., Pakter, J., & Katz, S.H. (1974). Maternal mortality associated with legal abortion in New York State: July 1, 1970--June 30, 1972. Obstetrics & Gynecology, 43 (3), 315-26. Retrieved January 26, 2006.

    4. Stroh, G., Katz, S.H., & Hinman, A.R. (1975). Performing second-trimester abortions. Rationale for inpatient basis. New York State Journal of Medicine, 75 (12), 2168-71. Retrieved January 26, 2006.

    5. Grimes, D.A., & Schulz, K.F. (1985). Morbidity and mortality from second-trimester abortions. The Journal of Reproductive Medicine, 30 (7), 505-14. Retrieved July 1, 2007.

    Source: Wikipedia.org: Hysterotomy Abortion








    EXPECTED OUTCOME

  • Termination of the pregnancy.


  • Expect complete healing without complications. Allow yourself several weeks for recovery from surgery.





  • POSSIBLE COMPLICATIONS

  • Excessive bleeding.


  • Surgical-wound infection.


  • Depending upon the type of uterine scar, there is often an increased risk of uterine rupture in a future pregnancy.




  • POST PROCEDURE CARE


    GENERAL MEASURES

  • Use sanitary pads for bleeding, which may last for several days. If bleeding continues 10-14 days after surgery, you may then use tampons.


  • If you have pain, place a heating pad or hot-water bottle on the abdomen or back. Hot baths frequently promote muscle relaxation and relieve discomfort. Repeat the baths as often as they provide comfort.


  • If contraception is desired, it can often be initiated shortly after the procedure. If you wish to take birth control pills, begin taking them either on the night you return from surgery or the next day. If you prefer an IUD, diaphragm or cervical cap, the fitting can be made during you next clinical appointment.


  • Your next menstrual period should begin 4 to 6 weeks after the procedure. If you take birth control pills, your first period will begin after you complete the first cycle of pills.





  • MEDICATION

  • Prescription pain medication should generally be required for only 2 to 7 days following the procedure.


  • You may use non-prescription drugs, such as acetaminophen, for minor pain.


  • Antibiotics may be prescribed to reduce risk of infection.


  • Stool softener laxative, if needed to prevent constipation.





  • ACTIVITY

  • Have someone drive you home from surgery. Resume normal activities slowly.


  • Avoid sexual relations for 4 to 6 weeks after the surgery.





  • DIET

    No special diet.



    NOTIFY YOUR MIDWIFE OR HEALTH CARE PRACTITIONER IF...

    Any of the following occurs:

  • Pain, swelling, redness or drainage increases in the surgical area.


  • You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and a temperature of over 100°F orally.


  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects.





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