Management of Individuals with Bleeding or Thrombotic Disorders Undergoing Abortion

Patient Guideline Summary

Publication Date: March 22, 2021

Objective

Objective

This patient summary means to discuss key recommendations from the Society of Family Planning for the management of management of individuals with bleeding and thrombotic disorders during abortion.

Overview

Overview

  • Abortion describes the removal of a preborn baby from the womb.
    • Abortion can be done using medicines or surgical procedures.
  • There are two kinds of blood disorders that are major concerns for surgery and for medical procedures that cause bleeding — clotting and failure to clot. Either poses a problem.
    • Thrombosis (harmful blood clotting) stops blood flow to parts of the body. The parts affected can die or stop functioning.
    • Excessive bleeding is either a hereditary condition, an acquired blood disease, or the result of taking blood thinners to prevent harmful clotting.
  • This patient summary focuses on the management of bleeding and thrombotic disorders in patients undergoing abortion.

Diagnosis

Diagnosis

  • The abortion procedure chosen varies with the duration of the pregnancy and your specific blood disorder. Therefore, you will be evaluated carefully so the best options can be selected.

Treatment

Treatment

  • ​​​​​​​In preparation for your procedure, several factors must be considered. They include:
    • Which trimester your pregnancy is in
    • Whether to choose a medical or a surgical abortion
    • Whether to use an out-patient facility or a hospital-based setting
    • If you are taking blood thinners for excess clotting, whether to continue, reduce or suspend those medications
  • If you need clotting factors to correct a bleeding tendency, they must be replaced to normal levels.
  • If you have had an incomplete abortion, surgical removal of the remaining uterine contents is recommended over medical treatment.
  • After your abortion, non-steroidal anti-inflammatory drugs (NSAIDs) are usually recommended for pain relief.
    • NSAIDs may interfere with other medications you are taking, so a careful review of them is important.
  • A levonorgestrel intrauterine device (IUD) is recommended for contraception (birth control) after delivery.

Abbreviations

  • IUD: Intrauterine Device
  • NSAIDs: Non-Steroidal Anti-Inflammatory Drugs

Source Citation

Lee JK, Zimrin AB, Sufrin C. Society of Family Planning clinical recommendations: Management of individuals with bleeding or thrombotic disorders undergoing abortion. Contraception. 2021 Aug;104(2):119-127. doi: 10.1016/j.contraception.2021.03.016. Epub 2021 Mar 22. PMID: 33766610.

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.