A 10-week-old fetus removed via a therapeutic abortion from a 44-year-old woman diagnosedwith early-stageuterine cancer . The uterus (womb), included the fetus.
Spontaneous abortion (also known as miscarriage) is the expulsion of an embryo or fetus due toaccidental trauma or natural causes before approximately the 22ndweek of gestation; thedefinition by gestational age varies by country. Most miscarriages are due to incorrect replicationof chromosomes; they can also be caused by environmental factors. A pregnancy that ends before 37 weeks of gestation resulting in alive-borninfant is known as a " premature birth".When a fetus diesin uteroafter about 22 weeks, or duringdelivery, it is usually termed"stillborn". Premature births and stillbirths are generally not considered to be miscarriagesalthough usage of these terms can sometimes overlap.Between 10% and 50% of pregnancies end in clinically apparent miscarriage, depending uponthe age and health of the pregnant woman. Most miscarriages occur very early in pregnancy, inmost cases, they occur so early in the pregnancy that the woman is not even aware that she was pregnant. One study testing hormones for ovulationand pregnancy found that 61.9% of conceptuseswere lost prior to 12 weeks, and 91.7% of these losses occurred subclinically,without the knowledge of the once pregnant woman.The risk of spontaneous abortion decreases sharply after the 10th week from thelast menstrual period(LMP). One study of 232 pregnant women showed "virtually complete [pregnancy loss] by the end of the embryonic period" (10 weeks LMP) with a pregnancy loss rate of only 2 percent after 8.5 weeks LMP.The most common cause of spontaneous abortion during the first trimester is chromosomalabnormalities of the embryo/fetus,
Advancing maternal age and a patient history of previous spontaneous abortions are the two leading factors associated with a greater risk of spontaneous abortion. A spontaneous abortion can also be caused by accidentaltrauma;intentional trauma or stress to cause miscarriage is considered induced abortion or feticide.
A pregnancy can be intentionally aborted in many ways. The manner selected depends chieflyupon thegestational ageof the embryo or fetus, which increases in size as the pregnancy progresses. Specific procedures may also be selected due to legality, regional availability, anddoctor-patient preference. Reasons for procuring induced abortions are typically characterized aseither therapeutic or elective. An abortion is medically referred to as atherapeutic abortionwhenit is performed to:
"Medical abortions" are non-surgical abortions that use pharmaceutical drugs. As of 2005,medical abortions constitute 13% of all abortions in the United States. Combined regimensincludemethotrexateor mifepristone, followed by a prostaglandin(either misoprostolor gemeprost: misoprostol is used in the U.S.; gemeprost is used in the UK and Sweden.) Whenused within 49 days gestation, approximately 92% of women undergoing medical abortion with acombined regimen completed it without surgical intervention. Misoprostol can be used alone, but
has a lower efficacy rate than combined regimens. In cases of failure of medical abortion,vacuum or manual aspiration is used to complete the abortion surgically.
A vacuum aspiration abortion at eight weeks gestational age (six weeks after fertilization).
Attached to a suction pumpIn the first 12 weeks,suction-aspirationor vacuum abortion is the most common method.
(EVA)abortion uses an electric pump. These techniques are comparable, and differ in the mechanismused to apply suction, how early in pregnancy they can be used, and whether cervical dilation isnecessary. MVA, also known as "mini-suction" and "menstrual extraction", can be used in veryearly pregnancy, and does not require cervical dilation. Surgical techniques are sometimesreferred to as 'Suction (or surgical) Termination Of Pregnancy' (STOP). From the 15th week until approximately the 26th,dilation and evacuation(D&E) is used. D&E consists of openingthecervixof the uterus and emptying it using surgical instruments and suction.
(D&C), the second most common method of surgical abortion, is astandard gynecological procedure performed for a variety of reasons, including examination of the uterine lining for possible malignancy, investigation of abnormal bleeding, and abortion.