Safety of midterm abortion?

Patient's question:

Is midterm abortion safe? What are the postoperative precautions? Pregnant for 6 months

Doctor's answer:

Hello, there are several methods for midtrimester induction of labor. However, due to the longer gestational period and larger fetus, complications may easily occur during and after induction, including the following:
Post-abortion hemorrhage: When the bleeding amount exceeds 400 milliliters after the fetus is delivered, it is referred to as post-abortion hemorrhage in midtrimester. If there is a large amount of bleeding in a short period, the patient may go into shock and be at risk of life-threatening conditions. Causes of bleeding:
① Ineffective uterine contraction after delivery: This is the most common cause of post-abortion hemorrhage. Under normal circumstances, after the fetus is delivered, the placenta separates quickly and is expelled. The blood vessels on the uterine wall then close due to uterine contractions, and bleeding gradually stops. However, certain factors, such as existing uterine fibroids or uterine developmental abnormalities, can lead to poor uterine contraction, resulting in postpartum hemorrhage. In such cases, strong massage of the uterine fundus or manual compression of the uterus should be performed under medical guidance to promote uterine contraction. If necessary, clots in the uterine cavity should be removed under sterile conditions, and uterine contraction drugs, such as oxytocin or ergot, should be administered. If bleeding persists, packing the lower one-third of the vagina with ethanol-soaked gauze may be used to stop the bleeding.
② Bleeding caused by placental issues: Bleeding before the fetus is delivered may be due to placenta previa or partial placenta previa; or it may be caused by partial early placental abruption. Incomplete placental separation after fetal delivery, where only part of the placenta detaches from the uterine wall while the rest remains attached or partially retained in the uterine cavity, can affect uterine contraction and lead to bleeding. Sometimes, part of the placenta adheres to the uterine wall and cannot naturally detach, resulting in bleeding from the other detached parts. This type of bleeding is often more severe. The above complications may occur.