Current technology can help make pregnancy termination safer.
The World Health Organization has defined the following methods for safe pregnancy termination:
1) Manual Vacuum Aspiration (MVA)
This method can be performed up to approximately 10 – 12 weeks of pregnancy. The equipment used consists of various sizes of plastic tubes paired with a vacuum syringe. When the doctor inserts the plastic tube into the uterine cavity, it can extract tissue from the uterine cavity, which can result in a complete abortion in nearly 100% of cases.
In Thailand, there is an effort to discontinue the method of pregnancy termination by curettage (D&C: Dilatation and Curettage or the use of medical instruments to remove uterine tissue) and replace it with Manual Vacuum Aspiration (MVA). The Ministry of Public Health and the Royal Thai College of Obstetricians and Gynecologists have organized training for obstetricians to widely develop skills in using MVA. Currently, both public and private healthcare facilities that provide pregnancy termination services for pregnancies not exceeding 12 weeks use this method, which can be performed without an overnight stay.
2) Use of medication for pregnancy termination The medications currently used and recognized by the World Health Organization for pregnancy termination are Mifepristone (also known as RU486) and Misoprostol (commercially known as Cytotec®). The method of medication-induced pregnancy termination can be divided into two types:
1.1 Use of Mifepristone (RU486) in combination with Misoprostol before 9 weeks of pregnancy
Thailand has implemented this combined medication method as a pilot service in hospitals to establish appropriate service guidelines since 2011. It was found that complete abortion occurred in 97% of cases. Between 2015 – 2016, Thailand conducted a clinical study on the use of these two medications for pregnancies of 9 – 14 weeks, in collaboration with 10 countries worldwide. The data is currently being analyzed and summarized to determine an effective medication formula and usage method.
1.2 Use of Misoprostol alone In cases where the pregnancy is between 12 – 20 weeks, it can result in a complete abortion in more than 80% of cases. This method is specified for use in hospitals for pregnant women admitted for treatment only.
The Royal Thai College of Obstetricians and Gynecologists has developed “Guidelines for Pregnancy Termination to Prevent Unsafe Abortion” for medical personnel to use as a service guideline. You can click to view the guideline details from the link: https://rsathai.org/en/contents/25591