Medical termination of pregnancy is permitted up to 20 weeks of gestation or fifth month of pregnancy.
The common reasons for MTP are: when continuation of pregnancy might endanger the life of the pregnant woman or cause grave injury to her physical or mental health, Eugenic reasons: when there is substantial risk of the child being born with serious handicaps due to genetic reasons, humanitarian reason: when pregnancy is caused by rape, etc,
Social reasons: Where the actual or reasonably foreseeable environment might lead to risk of injury to health of the mother or where there has been failure of contraceptive devices or methods.
Person who can perform MTP: Only a Registered Medical Practitioner having gynecological and obstetric experience can perform an abortion where the gestational period does not exceed 12 weeks.
Methods for MTP: Various methods are employed for the medical termination of pregnancy depending upon the month and duration of pregnancy. These can be classified into:
First Trimester Pregnancies: Menstrual regulation; by giving drugs, dilatation and suction curettage, dilatation and evacuation curettage.
Second Trimester pregnancies: Surgical evacuation is done by dilatation and suction evacuation; aspirotomy; hysterotomy and rarely hysterectomy, intra-amniotic instillation of drugs by hypertonic saline; urea; prostaglandins and others, extra-ovular instillation of drugs by Ethacridine lactate; hypertonic saline and prostaglandins, intrauterine instillation of devices like bougies; catheters and metreurynters, and lastly, extra-uterine methods like parental prostaglandins and oxytocics.
The above methods can be used singly or in combination. The administration of oxytocic drugs helps to stimulate myometrial activity and shorten the induction- abortion interval.
Method of D& C: Dilatation and suction curettage remains the most efficient method for termination of pregnancies up to 12 weeks of gestation and has become popular worldwide.
The procedure involves dilatation of the cervix by instruments or by hydrophilic laminaria tent followed by insertion of a suction canula of appropriate diameter into the uterine cavity.
The rule of thumb is to dilate the cervix up to the number of gestation weeks and follow it up with aspiration with the suction curette until a grating sensation is obtained all around and no further aspiration follows. The anesthesia commonly used is para-cervical block.