Medically Terminated Pregnancy

In the early stages of pregnancy, that is, between seven to nine weeks of pregnancy, the pregnancy can be terminated using medications. Surgery will be required if one wishes to terminate a pregnancy after that term.

Advantages:
MTP has the following benefits:

1. No surgery and therefore no need for anesthesia
2. Can be performed as soon as you know that you are pregnant
3. Simple and effective procedure
4. Non-invasive procedure 
5. Feels more natural
6. No hospitalization is needed and you can go home once the bleeding and cramping occurs

Disadvantages:
An MTP has the following disadvantages:

1. Painful, heavy bleeding and abdominal cramps for a few days after the procedure
2. Cannot be done after seven weeks of pregnancy
3. May cause incomplete abortion 
4. Higher failure rate compared to abortion surgery 

Contra-indications:
MTP is not recommended in women with the following conditions:

• Chronic adrenal failure
• Use of long-term corticosteroids
• Too far along in the pregnancy (more than 9 weeks)
• Ectopic pregnancy (pregnancy that occurs outside the womb or uterus)
• Presence of an intrauterine device or IUD
• Known allergy to medications
• Presence of certain medical conditions
• Bleeding disorders
• Blood vessel or heart-related complications
• Uncontrolled seizure disorder
• Anemic patient
• Presence of an ovarian mass
• No access to emergency medical treatment 

Symptoms

A woman may undergo MTP in the following circumstances:

1. Presence of severe disease and pregnancy may cause the end of life
2. Fetus is unhealthy physically or mentally
3. Pregnancy can endanger the mental and physical health of the woman
4. Pregnancy that occurs as a result of rape or an unwanted pregnancy
5. Socioeconomically unstable woman
6. Contraceptive failure resulting in pregnancy 

Diagnosis

1. Physical examination: The doctor will evaluate the overall physical health of the woman and ask about her medical and pregnancy history.
2. Pelvic exam: The doctor will insert one or two lubricated, gloves fingers into the woman’s vagina to check the internal female reproductive organs.
3. Ultrasound: This test helps the doctor to check how far along is the pregnancy and also to confirm that it is not an ectopic pregnancy (outside the womb or uterus) or molar pregnancy (development of a tumor in the uterus).
4. Blood tests: Certain underlying medical conditions can be diagnosed using these tests.
5. Urine tests: They help in detecting the presence of any urinary infections and also confirm a pregnancy.

Treatment

Medications can be either given orally or through the vagina in the case of MTP. No anesthesia or surgery is needed. The procedure involves the use of a combination of two drugs, which when used together cause an abortion. The two drugs used for MTP are:

1. Mifepristone: This drug works by blocking progesterone. The uterine lining will become thin and the embryo will not stay attached without progesterone.
2. Misoprostol: This drug causes the contraction of the uterus, bleeding, and expulsion of the embryo.

The most common types of MTP involve the following:

1. Mifepristone and misoprostol (oral): Mifepristone can be taken under the supervision of your doctor. Misoprostol will be taken after 24 to 48 hours once you are home.
2. Mifepristone (oral) and misoprostol (buccal, vaginal, or sublingual): Misoprostol is dissolved in the cheek, under the tongue, or through the vagina about 24 to 48 hours of oral mifepristone.

Risks

The complications associated with an MTP are as follows:

1. Incomplete abortion
2. Need for surgical abortion
3. Failure of the procedure
4. Heavy bleeding
5. Prolonged bleeding
6. Fever
7. Infection
8. Discomfort of the digestive system 
9. Allergic reaction to the medicines used

After Procedure

1. The more severe side effects of MTP take place shortly after taking the second pill.
2. Once both doses of medicines have been taken, you may expect the following to take place:
3. Bleeding and cramping that starts about one to four hours after the consumption of the second pill.
4. Heavy cramping for many hours.
5. Heavy bleeding along with blood clots for the next many hours.
6. Chills or a low fever that lasts for about one day after taking the second pill.
7. It is normal to feel nauseous, dizzy, fatigued, and have diarrhea after taking both pills.
8. A follow-up appointment after two to three weeks is recommended to make sure that there are no complications after the procedure. 
9. Pain-relieving medications may be recommended to ease your pain and discomfort.
10. Although infection following MTP is uncommon, some doctors may prescribe certain antibiotics to be taken after the procedure.

Home remedies:

The following home remedies will help in easing your pain and discomfort after the procedure:

1. Pain-relieving medications can help in managing your cramps.
2. Hot packs can help in pain relief.
3. Massage the painful area well.
4. Avoid inserting anything into the vagina, including tampons for at least two weeks after the procedure.
5. Avoid sexual activity until the doctor permits the same.
6. Avoid heavy lifting and strenuous activities until the bleeding stops.
7. Avoid going swimming till your doctor gives the go-ahead for the same.

Cost of medically terminated pregnancy in India- 

The cost of a medically terminated pregnancy in Mumbai is between INR 1000 to INR 8000.
The cost of a medically terminated pregnancy in Delhi is between INR 750 to INR 7500.
The cost of a medically terminated pregnancy in Bangalore is between INR 750 to INR 7500.
The cost of a medically terminated pregnancy in Chennai is between INR 500 to INR 5000.