What is the difference between spontaneous abortion and medical termination of pregnancy?

Spontaneous abortion, also known as miscarriage, is the unintentional loss of a pregnancy before the 20th week of gestation. Conversely, medical termination of pregnancy is a deliberate procedure to end a pregnancy using medications or medical interventions, which must be performed under medical supervision [3].

Understanding Spontaneous Abortion (Miscarriage)

A spontaneous abortion occurs when a pregnancy ends on its own before the 20th week. Most cases of spontaneous abortion cannot be prevented, and they are typically not related to the mother's actions [3].

Understanding Medical Termination of Pregnancy

Medical termination of pregnancy is a procedure performed intentionally to end a pregnancy, either through medication or a surgical procedure. The type of procedure depends on several factors, including the gestational age and the patient's health status [2]. For example, medication abortion can be performed using medications such as mifepristone and misoprostol, which work to stop the pregnancy from progressing and empty the uterus [1]. Mifepristone is used in conjunction with misoprostol to terminate an intrauterine pregnancy up to 70 days (ten weeks) from the last menstrual period [1].

How does medical termination of pregnancy work?

Medication abortion typically involves a two-step process. First, mifepristone is taken to stop the pregnancy's growth by blocking progesterone, a hormone necessary for maintaining the pregnancy. After approximately 24 to 48 hours, misoprostol is taken, which causes contractions and bleeding to empty the uterus [1]. This procedure must be conducted under the supervision of a qualified healthcare provider [1].

Side effects and risks

Side effects of medication abortion may include vaginal bleeding that is heavier than a menstrual period, severe cramping, nausea, vomiting, fever, and chills [2]. It is critical to follow up with a physician to ensure the termination is complete and to manage any potential complications [2]. Rare complications that may occur following medical termination of pregnancy include retained products of conception, heavy bleeding, infection, or uterine injury [4]. In cases of severe bleeding (e.g., soaking through two large sanitary pads per hour for two consecutive hours), emergency care must be sought immediately [4].

When should you consult a doctor?

If you are considering pregnancy termination, it is essential to speak with a healthcare provider as soon as possible. A physician can discuss the available options, explain the procedures, outline the potential risks and benefits, and provide guidance on self-care after the procedure [2]. Additionally, an ectopic pregnancy must be ruled out before undergoing medication abortion, as mifepristone should not be used if an ectopic pregnancy is confirmed or suspected [1]. For further information regarding pregnancy termination in critical cases, you may visit Pregnancy termination options in critical medical cases (Arabic).

Medical references

• Questions and Answers on Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation
• Abortion Care
• Abortion
• Complications of an abortion - NHS