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ARTIFICIAL TERMINATION OF PREGNANCY IS A TOPICAL PROBLEM OF MEDICINE AND SOCIETY

Abstract: Currently, the issue of preserving the reproductive potential of women of childbearing age remains relevant. The leading problem is the increasing prevalence of the use of methods of artificial termination of pregnancy, which are one of the main links in the pathogenesis of infertility, miscarriage and delay in fetal development in subsequent pregnancies. In 33% of cases, artificial termination of pregnancy leads to complications: the frequency of early complications is 6-17%, the frequency of more severe late complications is 11-36%. In 18% of cases, this intervention leads to a fatal outcome. The article reflects a comparison of the main methods of termination of pregnancy, their advantages and disadvantages are evaluated. The leading histological changes of the endometrium after abortions (atrophy of the functional layer of the endometrium, necrosis, dystrophy, fibrosis of the stromal component, diffuse inflammation), hormonal disorders (decrease in the concentration of estradiol and testosterone in the blood by at least 1.8 times, significant androgenic activity of the adrenal glands without a tendency to normalization), oncological risks (imbalance of the ratio of estrogen metabolites towards increased synthesis of the metabolite 16-hydroxyestrone, which is characterized by 4 times more pronounced estrogen activity with suppression of apoptosis and increased proliferative changes with an increased risk of dysplastic processes and cervical cancer, endometriosis, leiomyoma, fibrocystic disease and breast cancer), psychological changes. As a prevention of unwanted pregnancy, the advantages of using the method of intrauterine contraception are present, due to the low number of complications during its use, the absence of cancer risk, the frequency of inflammatory processes slightly exceeding their frequency in the general population.