Tuesday , 27 June 2017
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Teenage pregnancy: How can it be handled?

Dr Kedar Padte

 

Teenage pregnancy is an ever agonising phenomenon that has been and will be.

We discussed contraception in the previous article to prevent pregnancy in the youth of today, but humans are major risk takers. When I tell a young boy that smoking is bad, he explains how his grandfather, who smoked all his life, never got cancer.

And similarly young girls forgo contraception, in the heat of the moment and hope they don’t get pregnant. Not all are lucky to escape. Girls who conceive and live in urban areas detect what is happening, seek urgent intervention and terminate the pregnancy.

A few are either scared, ignorant or both and are detected with a pregnancy between 18 and 20 weeks, which still within the legal limits of abortion.

What should be done with an unwanted teenage pregnancy?

One must note the time of missed period and should approach a gynaecologist and get adequate tests and pills (RU-486) and get relief.

The tablet RU 486 or Mefipristone is still effective after three weeks have passed after missed period, up to 7 weeks pregnancy. There can be a lot of risk such as incomplete abortion, severe haemorrhage, sepsis and pain beside vaso-vagal attacks and fainting. This should never be taken without a qualified gynaecologist overlooking your situation.

If the pregnancy has progressed beyond 7 weeks and is less than 13 weeks, termination will need to be done by an experienced gynaecologist. To evacuate the same dilatation of cervix and evacuation of the pregnancy under local (para-cervical) or general anaesthesia is required.

This too has many possible complications ranging from haemorrhage, cervical tear, uterine perforation, infection and subsequent infertility.

If the pregnancy is beyond 13 weeks and less than 20 weeks, the termination will be stressful to both obstetrician and patient.

Prostaglandin drugs are available in various forms to induce labour pains and augment dilatation of the cervix with oxytocin back up to expel the unwanted child. This often needs evacuation to remove placental tissue that has not been expelled. All complications mentioned earlier can also happen here. Any pregnancy that has to be terminated beyond 12 weeks has to be decided by two qualified gynaecologist.

A pregnancy that is beyond 20 weeks cannot legally be terminated and has to be allowed to go to viability. Such a pregnancy involves complications such as anaemia, high blood pressure, premature delivery, partum and postpartum haemorrhage.

Preterm delivery is very common and the life of the preterm child is subjected to conditions that lead to increased perinatal morbidity and mortality.

Although today’s science has all the means to support this pregnancy and the baby, the unwanted child is likely to go through disastrous upbringing.

The incidence in certain western countries is high enough to have special schools/college classes to allow teenage mothers to complete their courses while completing the traumatic pregnancy.

Don’t get too shocked!

Look before you leap

Think before you…

 

 

(Columnist is a well-known gynaecologist practising in Panaji. Send in your queries to padte.kedar@gmail.com)

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