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  Pregnancy & Motherhood

June 2012
Abortion: Is Infertility Inevitable?
Dr Arcot Jaishree Gajaraj
 
Early loss of pregnancy can be either spontaneous or induced. When it is the latter, it is achieved either through medication or done surgically by dilatation and curettage (D&C).

From a purely clinical point of view, abortion is a safe procedure when performed under the supervision of a qualified medical professional and under appropriate sanitary conditions. There is no scientific evidence to show that a woman going in for an abortion risks infertility. An improperly done abortion can however lead to infection and result in sub-fertility.

Causes of infection
  • Incomplete evacuation of the uterus during abortion leads to infection. It may be contracted through the vagina, blood or surgical intervention.
  • Products retained inside the uterus during the procedure can result in pelvic inflammatory disease (PID).
Complications from PID
Instances of PID leading to hospitalisation are rare but it is something that has to be factored in. Cases where the infection persists silently or remains asymptomatic are the cause of sub-fertility.

Consequences of PID
  • Inflammation of the reproductive organs
  • Blockage in the fallopian tubes
  • Swelling in the fallopian tubes
  • Infection in the inner lining of the uterus
  • Sticking of uterus, tubes and ovaries
  • Adhesion of small and large intestines
  • Risk of an ectopic pregnancy
Treatment
  • X-ray, HSG or Laparoscopic Dye test is used to diagnose blockage in the tubes
  • Laparoscopy is used to visualize pelvic adhesions
  • Tubes are removed in case the swelling is excessive
  • Women with excess tube damage are advised assisted reproductive procedures

Awareness among both the patients and the public is very important in the prevention of PID and in checking its consequences. Women undergoing abortion should always make sure the procedure is carried out correctly and spare themselves any long-term side effects.
Dr Arcot Jaishree Gajaraj Sr Consultant Gynaecologist Apollo Speciality Hospital Chennai

    
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