Cleaning after medical abortion. Early complications after medical abortion. Contraindications to pharmaboration and complications

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Questions and answers on: cleaning after medical abortion

2007-08-20 15:38:56

Luda asks:

After a medical abortion, clots remained in the uterus, ovum it came out. The doctor prescribed a drug with progesterone and after menstruation again for an ultrasound. I would like to know how likely a positive outcome is or will I have to suction? And what are the possible complications if I still do not agree to cleanse?

Answers Karapetyan Eliz Martinovna:

The doctor is doing absolutely the right thing. And if it doesn’t help, you will do curettage, there are no other options. Complications are dangerous because they can lead to irreversible consequences on the pelvic organs.

2016-07-12 17:08:37

Marina asks:

Hello. I’m 22 years old. It so happened that I had to have a medical abortion, then they did a cleansing because there were clots in the uterine cavity, they gave me IVs, on a control ultrasound everything was fine, I was discharged. After I returned home, literally a couple of days later there was a sign on my face A rash appeared, I’ve never had anything like this before, my entire forehead, cheeks, and nose were covered in small acne. The day after the abortion, they prescribed hormonal drugs (Jazz), supposedly to improve the hormonal balance. I’ve been taking it for three weeks and don’t know if it’s worth continuing. A gynecology nurse I know tells me that under no circumstances should I I drank them girlfriends too negative reviews, in There is also a lot of negativity on the Internet, especially about how difficult it is to “get off” from them later. And will they really help restore hormonal levels? After all, for some reason they didn’t do any hormone tests for me. And why did acne appear? How long will it take for this to go away now? I will be very grateful for your answer.

Answers Palyga Igor Evgenievich:

Hello, Marina! The rash is most likely due to hormonal imbalance(increasing testosterone levels in particular). In this case, COCs are actually prescribed for recovery hormonal levels. IN this moment no acne? You can take COCs for 1-3 months or longer if desired. I don’t quite understand why the nurse is so categorical?! Jazz is quite suitable for your age. Taking COCs causes much less damage to the body than abortion and purging!

2015-06-26 19:54:24

Polina asks:

Hello! I registered with antenatal clinic due to pregnancy, the child was wanted... My doctor referred me for screening. Unfortunately, the ultrasound confirmed that the pregnancy was dead (7-8 weeks). The Uzis doctor (I don’t know if I’m calling it correctly) suggested a medical abortion in private clinic where he also works. He said that a dead fetus “won’t last” even at this period. They gave me two tablets to take there and two to take with me, and told me to take them in 48 hours. After taking the second pair of tablets, bleeding began. The fruit has been coming out in parts for 2 days. When will it come out completely? And when should I go for an ultrasound (to check for residues)? I had doubts whether they did everything right for me. I categorically did not want to do the cleaning because the news that the pregnancy was lost killed me. I didn’t want to completely finish off my health and psyche with scraping. Because I've already been through this. Thank you very much for your answer!

2013-10-12 01:34:01

Louise asks:

Hello. According to honey indications, I had to go for a medical abortion. The term was 4-5 weeks, an ultrasound before the abortion showed that detachment had begun, there was some kind of hematoma, the doctor said that this happens from stress. I took a mifepristone tablet at the clinic, and they gave me two myrolutes with me. After taking mefipristone, 36 hours later, dark red - almost black clots began to stand out without any pain. And already at the appointed time I drank Mirolut, with terrible pain and wild spasms, discharge began again, and then some kind of yellow-orange clot came out, after which the bleeding intensified, and then became slow again. Tell me, is this all normal?
I’m very afraid to go for cleaning, they say that this often happens when the PJ does not come out completely.
How long after MA will it be safe for yourself and your baby to get pregnant?
Thanks for the answer.

Answers Kolotilkina Tatyana Olegovna:

Hello Louise. Heavy discharge and pain accompany medical abortion. The doctor should have prescribed ultrasound monitoring for you after this. I advise you to do it and not wonder if everything worked out. And then, if everything is fine, if there is no need to do curettage and there is no inflammation, we can already talk about the time of the planned pregnancy.

2013-09-19 15:52:14

Rita asks:

Hello! Please help me figure it out...

I was pregnant, everything went well, I had a confirmatory ultrasound at 2 weeks and a heart test at 6 weeks. The pregnancy was planned, desired, the first one. There was never an abortion. next ultrasound at 12 weeks, the ultrasound specialist informed me that I had a frozen pregnancy. I was immediately sent for cleaning. During pregnancy, nothing hurt, there was no discharge, my breasts still ached, my nipples were also enlarged and sensitive. when the ultrasound specialist reported that the fetus does not develop for 12 weeks, and on the sheet she wrote that the heartbeat cannot be heard and a medical abortion is needed... then everything is in a fog... the next 3 days are like in a dream... you don’t understand anything....
The histology result came back.
Histology conclusion: no signs of trophoblast were found in short-term pregnancy.
does that mean the fetus was alive?
Later, after the cleansing, having studied this issue, I know that doctors often make mistakes and they rush to do the cleansing.
The gastrointestinal doctor didn’t say anything, looking at the sheet... she simply said that there was no inflammation.
but I already know this, because my husband and I planned our pregnancy and passed all the tests before conception, everything was clean, everyone was healthy.
What does the histology result mean?
otherwise, now we are trying to understand the reasons why this happened... how and why this could happen.

Answers Korchinskaya Ivanna Ivanovna:

According to statistics, 10% of pregnancies end in miscarriage, unfortunately. The tactics of your doctors were correct; the pregnancy froze early, and not at 12 weeks. Trophoblast is embryonic tissue; if it is not detected during histology, it means that either the embryo has frozen early stage, or came out with discharge and was not included in the material sent for histology.
In any case, you need to survive this unpleasant episode and plan next pregnancy in three months, when the body has fully recovered.
I wish you success!

2011-09-20 13:09:16

Nadezhda asks:

Hello! I am 34 years old. Two births, cesarean, 1 - abruption of a normally located placenta, 2 - abruption of a centrally located placenta.
My last period was June 29, 2011.
08/03/2011 I found out that I was pregnant - positive test. I decided to terminate the pregnancy and turned to a hygiologist. I was recommended a medical abortion. The doctor said that after taking the pills, I would have my period for a few days and that’s all.
On August 12, 2011, I took the first three tablets, and 36 hours later, two more. For five days I felt very weak, then my stomach began to hurt badly, and bleeding began at night (2 minutes of padding). I went to the doctor, she recommended injecting ositocin and dicinone.
On August 18, 2011, they did an ultrasound scan and said that there was no fertilized egg in the uterus, they recommended taking an anthebiotic for 5 days and injecting oxytocin for 3 days.
Basically, if oxytocin is injected, everything is fine, if not, there is bleeding.
On September 07, 2011, I had a second ultrasound scan and was sent to the hospital, diagnosed with an ectopic pregnancy. At the hospital, they performed a curettage, said that they had removed the fertilized egg from the uterus, and prescribed antibiotics. After cleaning there was no quori at all. But since September 19, 2011, it has been bleeding again, ultrasound shows an accumulation of fluid in the uterine space, pressing on the rectum. What should I do?

Answers Tovstolytkina Natalia Petrovna:

Hello, Nadezhda. The appearance of liquid in posterior fornix most often has two causes - it is effusion in acute inflammatory processes or blood from a disturbed tubal pregnancy. Both the first and second options require hospitalization. Considering your complicated medical history (caesarean section, placental abruption), as well as the history of this pregnancy, you definitely need hospitalization with mandatory control blood clotting (coagulogram).

2011-05-06 16:15:13

Ilona asks:

Hello! I am 28 years old, yesterday I found out at an ultrasound that I was pregnant. The period is 3-4 weeks. Due to some circumstances, I was forced to decide on a medical abortion. The doctor immediately gave me tablets, 1 Mytholian, told me to drink at home at 16:00 on an empty stomach and not eat anything for 2 hours. And 2 more tablets, there are no names on them, drink them on 05/7/11 at 6- 7 am. And she said that everything should come out. Then come back a week later for a follow-up ultrasound. I was just a little in a state of shock, so I reacted negligently and didn’t ask questions. Yesterday I took a pill, and today, having read on the Internet that a medical abortion takes place by taking 3 pills, I’m mistaken. I ask for your advice whether everything will work out after taking these pills or not. Or most likely I will have to do cleaning, I am very worried. Tomorrow I need to take these 2 more tablets. Please help! Thank you in advance!

The consequences of medical abortion are less dangerous than surgical ones, but in the absence of qualified assistance they can lead to infertility and even fatal outcome. Taking pills is not difficult, however, despite the apparent simplicity of the procedure, it causes major changes in the body: a large dose of hormones affects reproductive system, disrupts the natural processes of preparation for bearing a fetus.

Vomit

This complication develops in approximately 44% of women with orally misoprostol, in 31% - with intravaginal. Studies also confirm that the frequency of vomiting is influenced by the interval between taking a hormonal drug (Mifepristone) and a prostaglandin (Misoprostol). The likelihood of this symptom is lower if the interval is 7-8 hours than with a daily break.

Nausea

This symptom is more common than others gastrointestinal disorders with medical abortion. It has not been fully established what exactly it is caused by: exposure to drugs or termination of pregnancy.

However, a trend has been identified in which nausea is more pronounced with a high dose of Misoprostol (a prostaglandin), rapid administration and a gestational age of 6-7 weeks. If vomiting occurs, you must inform your doctor. You may need to take the pills again.

Allergy

Allergic reactions as a consequence of medical abortion can develop to the components of any of the drugs taken. Most often it is a rash or hives. Severe manifestations, such as Quincke's edema and breathing problems, occur extremely rarely. To avoid this complication, after taking medications you should stay in a medical facility (clinic) for at least a few hours.

Diarrhea

Stool disorders develop in approximately 36% of women when taking Misoprostol orally and in 18% when taking Misoprostol intravaginally. The symptom may be varying degrees expressiveness. The effectiveness of taking antidiarrheals in such cases has not been proven. Diarrhea usually stops on its own after a few hours.

Severe abdominal pain

This symptom is caused by spasm of the uterine muscles, which is part of the mechanism of action of the hormonal drug. It is observed in 96% of women and is considered normal. The severity of pain can vary: from mild to unbearable. The symptom begins to increase rapidly 30-50 minutes after taking Misoprostol and most often goes away after the abortion is completed. There is a tendency that the shorter the pregnancy, the easier the pain.

To eliminate it, non-steroidal anti-inflammatory drugs (Ibuprofen, Naproxen) are used, in severe cases- narcotic painkillers (Codeine, Oxycodone).

Convulsions

Appear approximately 1.5-3 hours after taking Misoprostol. Most often localized in the groin area. They subside after the abortion is completed. A warm heating pad can be used to reduce pain.

All of the above complications do not require special treatment and most often go away on their own after the abortion is completed. When they are severe, symptomatic remedies are used.

Medium-term consequences and complications

Medium-term effects occur within a few weeks of medical abortion.

Bleeding

This symptom appears in early period, some time after taking the pills. If the bleeding volume corresponds to menstrual bleeding (no more than 1-2 pads per hour), lasts 7-14 days and gradually decreases, then there is no cause for concern - this is not a complication, but a normal process.

In some cases, women notice discharge for up to 30 days, but it is spotting and is not accompanied by pain or other symptoms. If the bleeding is heavy (2-3 or more pads per hour), prolonged and/or accompanied by pain, then you must immediately inform your doctor. This complication is rare and develops against the background of incomplete abortion or infection.

The longer the pregnancy, the higher the risk abnormal bleeding. In 0.4% of cases, blood transfusion is performed, in 2.6% - suction curettage. Without timely medical care death cannot be ruled out.

Continuing pregnancy or incomplete termination

In 1-4% of cases, the fertilized egg is not expelled from the uterus or is not completely expelled. This can happen for several reasons: the dose of the drug is incorrectly calculated, the timing of the procedure is too late, there are hormonal disorders or inflammatory processes in the woman’s body.

Such consequences after medical termination of pregnancy are accompanied by prolonged and undiminished bleeding, nagging or cramping pain in the lower abdomen, increased temperature, and fever. You cannot cope with them on your own; hemostatic drugs will not help.

An ultrasound and follow-up are required. If this is not done, then in the event of an incomplete abortion, the remains of the fertilized egg will lead to the spread of infection, general infection blood and fatal outcome. If the pregnancy continues to develop, then the risk of having a child with serious malformations is high.

Pain in the lower abdomen

Normally, cramps in the uterus gradually disappear after the abortion is completed. If the pain continues, this may be a sign of infection or incomplete termination of pregnancy. This symptom requires examination by a gynecologist and ultrasound.

Headaches and dizziness

These consequences of medical abortion develop in 20% of women. As a rule, the reason is big loss blood. Weakness, decreased blood pressure, and lightheadedness are also observed.

If dizziness is accompanied by bleeding, then the help of a doctor is necessary. In another case, you can take an analgesic, rest more often, and change your body position gradually.

Long-term effects and complications

Long-term consequences of medical abortion are rare but most difficult to treat. They appear after several months and even years.

Menstrual irregularities

If menstruation began on time (counting from the date of abortion) or was delayed by 7-10 days, this is a sign that sexual and endocrine system recovered. About 10-15% of women note that in the first few cycles, menstruation is more painful and heavy, but soon becomes the same as before.

A complication will be indicated by a delay of more than 40 days or heavy periods accompanied by cramps. intense pain, fever, deterioration in general health.

In the first case, either a re-occurrence of pregnancy is possible (this happens already 2 weeks after an abortion), or a disruption in the functioning of the ovaries. You need to see a doctor, he will determine the cause and prescribe necessary procedures. Oral contraceptives are often used to restore hormonal levels.

If your periods are very heavy, with severe pain and a rise in temperature, then perhaps particles of the fertilized egg remain in the uterus and/or an infection has developed.

After a doctor’s examination and ultrasound, curettage is performed and antibiotics are prescribed.

Infectious and inflammatory diseases

Develops after medical abortion as an exacerbation chronic forms or due to remaining particles of the fertilized egg. If a woman had hidden, sluggish infectious and inflammatory processes (salpingitis, gonorrhea, etc.) before the abortion, then after the abortion procedure they may begin to progress.

This is manifested by pain in the lower abdomen, discharge with unpleasant smell And greenish color, purulent impurities, increased temperature. After laboratory diagnostics the doctor prescribes antibiotics, most often in a hospital setting.

Infertility

The reasons for this severe consequences hormonal disorders or inflammatory diseases of the uterus and appendages occur.

In the first case, the balance of male and female sex hormones is disrupted, as a result of which the process of fertilization of the egg and its attachment to the wall of the uterus is hampered.

Inflammatory processes can lead to the formation of adhesions and narrowing of the lumen of the fallopian tubes. This prevents the egg from moving to the uterus.

Changes in emotional state, character

Sometimes hormonal imbalance and the abortion procedure itself affect the characteristics of a woman’s psyche. She may become overly irritable, aggressive or whiny, depressed, lethargic.

At first, such reactions are observed only in difficult situations, for example, during or after a quarrel. But soon they become total, arising without external causes.

To eliminate the problem, you need to see a doctor: a psychiatrist or psychotherapist, or consult a psychologist.

Medical abortion and its consequences are still being studied. Research confirms that the earlier the abortion procedure is performed, the lower the risk of complications.

The most common among them are bleeding, pain in the lower abdomen, and infection. The consequences are related to hormonal disorders and the risk of incomplete release of the fertilized egg. Problems may occur menstrual cycle, development of inflammation, infertility.

Abortion is not completely safe procedure, even him the latest techniques may have dangerous consequences. The later the date of its implementation, the more dangerous complications can be. To avoid them, you need to approach contraception issues wisely. But if there is a need to terminate the pregnancy, then you should take care of it when complications are minimal.

Consequences of medical abortion

Usage pharmacological agents effective for abortion in 98% of cases. But after the procedure, complications also occur. Some of them can be classified as adverse reactions. This headache, allergy to the drug, dyspeptic symptoms. A small number of women develop these effects.

Headaches can vary in intensity. If the pain is severe, you need to measure arterial pressure, it is often the cause of this condition. Treatment is carried out by prescribing an antihypertensive tablet.

Dyspepsia in the form of nausea or vomiting does not require special treatment, but you can take a tablet of Metoclopramide, which is prokinetic and will quickly eliminate unpleasant symptoms.

An allergic reaction is individual feature. It may appear in the form acute urticaria, which is eliminated antihistamines: Cetirizine, Fencarol, Suprastin.

• Incomplete abortion

In 1-2% of cases drug interruption pregnancy may be complicated by incomplete abortion. A follow-up examination is scheduled 14 days after the procedure to ensure its success. If, according to the results of an ultrasound, remains of the fertilized egg are detected in the uterine cavity and remain copious discharge, this indicates the presence this complication. In this case, carry out, because tissue remnants will not allow bleeding to stop and can become a breeding ground for bacteria.

• Progressive pregnancy

Another complication is progressive pregnancy. In this case, an embryo is determined by echography, which corresponds to its development period. The doctor’s tactics depend on the woman’s wishes. If she changes her decision and wants to continue the pregnancy, she is registered and examined according to the protocols. For those who still wish to terminate the pregnancy, vacuum aspiration or surgical abortion depending on gestational age.

• Increase in temperature and painful sensations

Sometimes on medications taken arises adverse reaction in the form of an increase in temperature. If this happened after a few hours, then there is no need to worry. An increase to low-grade levels is allowed, which does not last longer than a new day.

Pain after taking Misoprostol is natural consequence, it's being cut muscle cells- myometrium, which ensures the expulsion of the fertilized egg. The sensations are reminiscent of contractions varying intensity. If the pain is very severe, anesthesia may be needed. In this case, antispasmodics are used - Drotaverine (No-shpa). Non-steroidal anti-inflammatory drugs Ibuprofen, Indamethacin, Aspirin are not recommended for use. Their action is based on the blockade of prostaglandins, so the effect of abortion drugs may be reduced.

• Bleeding

Bleeding is normal reaction body to take Mifepristone and Misoprostol. But sometimes strong bloody issues that cause concern. To react correctly, you need to be able to distinguish pathological discharge from the norm. When using two or more pads every hour, and this continues for at least 2 hours, this is bleeding. The condition requires medical attention.

To stop bleeding, in most cases, the condition of the pelvic organs is checked by ultrasound. Rarely, the remnants of the fertilized egg prevent the uterus from contracting normally, so bleeding takes a long time to decrease. To treat the condition, they resort to curettage of the uterine cavity.

Also unfavorable is the absence of bleeding or its sudden cessation. The absence of blood may indicate a failed miscarriage, which requires another. An abrupt cessation of discharge is an indicator of spasm internal pharynx cervix. To eliminate it, Drotaverine is prescribed.

• Hormonal imbalance

The most severe long-term consequence termination of pregnancy is a hormonal imbalance. It is believed that when performing a medical abortion on early stages its course resembles a natural miscarriage and does not affect hormonal cycle. But 63 days are allotted for performing a pharmacological abortion. Performing manipulation for more later may lead to hormonal imbalance.

Danger of vacuum aspiration

Spontaneous abortion

In some cases, termination of pregnancy occurs independently without the participation of a doctor or the desire of the woman. Complications also develop after spontaneous abortion. Miscarriage often occurs due to a genital tract infection. Therefore, the ascending path of pathogen penetration into the uterus can lead to damage to the endometrium, appendages, parametrium, as well as the development of peritonitis and sepsis.

Spontaneous abortion before 22 weeks may be accompanied by massive bleeding. Its consequence is disseminated intravascular coagulation syndrome. At the same time, it is released from the placental tissues a large number of substances that lead to hypercoagulation and the formation of blood clots. Then this condition is also rapidly replaced by hypocoagulation and the development of massive bleeding.

Treatment should begin with an emergency transfusion of blood plasma, which contains the main clotting factors. Further therapy is carried out with Heparin, Aminocaproic acid, and the antienzyme Contrikal. State of shock treated with transfusions of blood substitutes, narcotic analgesics, and glucocorticoids. The dosage is selected individually based on the characteristics of the patient’s condition.

If the cause of spontaneous abortion is not established, it may recur in subsequent pregnancies. If more than 2 miscarriages occur, then they talk about habitual miscarriage. This condition may be a consequence of:

• frequent abortions;
• genital tract infections;
• genetic pathologies of the fetus;
• antiphospholipid syndrome.

When spontaneous miscarriage begins, conservation therapy is carried out. To relieve uterine tone, a solution of magnesium sulfate is injected drip-wise and Indomethacin is given. Appointed bed rest, sometimes it is recommended to slightly raise the foot end of the bed. To stop bleeding, aminocaproic acid and Dicinone are administered. Also effective hormone therapy with a lack of progesterone. But if the bleeding is heavy, hormonal drugs won't help. If infected, antibiotics are prescribed.

In addition to health complications, termination of pregnancy carries a heavy psychological burden. Women who decide to take such an action are prescribed a consultation with a psychologist. Those who develop complications after an abortion of various nature or infertility, they often regret their choice.

[content h2]Except diagnostic procedure, intended for conducting a detailed examination of uterine tissue, curettage is also performed for the purpose of terminating pregnancy. Women are better known and understand the term “abortion,” which often means instrumental curettage of the uterus. If in the early stages it is possible to stop the development of an unwanted pregnancy using more gentle methods, then after 6-8 weeks it will be necessary surgical intervention with the extraction of the fetus and membranes from the uterine cavity.

What is uterine cavity curettage?

Curettage as a method of terminating pregnancy is the most effective existing method. The result of the manipulation is assessed by a doctor on site, in the hospital, and a thorough mechanical restoration organ minimizes the risk of leaving part of the embryo behind.

Indications for curettage and possible timing of its implementation

In addition to a woman’s personal desire to terminate a pregnancy, there are also medical indications for its termination. These include:

– serious illnesses most pregnant woman, exacerbation serious pathologies(oncology, systemic autoimmune diseases etc.);

- some viral infections, infection with which occurred in early pregnancy;

– incompatible with life or disabling malformations of the fetus.

Time frame for performing curettage

Up to 12 weeks - according to indications or at the request of the pregnant woman.
From 12 to 18 weeks - exclusively medical indications. In this case, the operation can be complemented by a number of other procedures to extract the fetus.

How is curettage performed?

Before surgery, a vaginal examination is performed to accurately determine the position, size and shape of the uterus. You will also need to consult an anesthesiologist to find out contraindications to anesthesia and select its method.

Most often, the patient is given instant intravenous anesthesia directly on the operating table, having previously installed a catheter for the possible addition of a portion of the drug during manipulation. In rare cases, abortion is performed using spinal anesthesia or endotracheal anesthesia.

The sequence of actions of the doctor during curettage:

1. Treating the genitals with alcohol or iodine solution.
2. Opening the vagina using gynecological speculum, cleansing the internal genital organs with an alcohol solution.
3. Expansion of the cervical canal by introducing tubes of different diameters (Hegar dilators).
4. Insertion of a curette into the uterine cavity, detection of the fertilized egg.
5. Destruction of fetal tissue by the curette. Additionally, it may be necessary to use an abortion forcemer, which easily grasps the fetus. This tool is used especially often during late pregnancy (13 weeks or more).
6. Removal of the fetus whole or in parts.
7. Curettage of the mucous membrane of the uterus and the remaining membranes of the fertilized egg until the walls of the organ are smooth.
8. Retrieving instruments.
The success of the operation is determined by the cessation of bleeding and the appearance of bloody foam.
9. All parts of the fruit are placed in a tray to confirm its integrity and complete removal.
Operations controlled using ultrasound sensors are considered more successful and faster. An examination using ultrasound or a hysteroscope is also required after surgery to avoid complications.

How to prepare for the procedure?

So that scraping takes place without unpleasant complications from the gastrointestinal tract, you should not eat 12 hours before surgery (especially if it is performed under general anesthesia). You should also empty your bowels and bladder immediately before the manipulation, perform a cleansing enema at home, and also carefully shave the pubic and perineal hair.

To perform curettage, you will need a consultation with an anesthesiologist and a number of tests and studies:

1. Gynecological examination.
2. Smear for oncocytology.
3. Strokes on infectious diseases genital area to prevent infection of the appendages during surgery.
4. Ultrasound of the uterus to determine the gestational age and the location of the fertilized egg.
5. Tests for HIV, hepatitis B, C, syphilis.
If STI pathogens are detected in smears, a course is carried out before the abortion. intensive care to eliminate the disease.

What discomfort might a woman experience?

If the operation is performed under general anesthesia, pain is completely eliminated. Nowadays, private and municipal clinics do not practice operations with local anesthesia lidocaine, which was previously the norm.

After curettage, pain often occurs, which is associated with the contraction of the uterine walls to their original size. The pain is aching or characterized by mild cramping attacks, similar to the sensations during menstruation. Only a small percentage of women need drug elimination discomfort, for others it does not exceed that during menstruation and lasts 1-5 days.

Signs of bleeding often appear, which normally ends quickly. Sometimes pain in the mammary glands develops - the result of changes in hormonal levels, which can be potentially dangerous due to the occurrence of mastopathy and fibrocystic pathologies.

Possible complications

Unfortunately, many women experience various complications after instrumental abortion. Among the primary, or early complications, the following are distinguished:

Most dangerous consequence life-threatening is uterine perforation(perforation). It can occur when curettage is performed by an unqualified doctor in the form of mechanical damage walls or their thinning due to the removal of an excess layer of mucosal tissue during surgery. If the contents of the uterus penetrate the peritoneum, there is a high probability of peritonitis and death. Perforation of the uterus often becomes the reason for its emergency complete removal.
Damage to the cervix abortion instruments. Threatens infertility or problems with subsequent pregnancy.
Bleeding. Instrumental abortion is especially dangerous for women with bleeding disorders. In this case, continuous bleeding can lead to anemia, fainting and even death. Excessive bleeding after curettage is a reason to sound the alarm. After numerous curettages, bleeding may intensify while still on the operating table, which is often an indication for blood transfusion and removal of the uterus.
The consequence of abortion is often genital infection due to penetration pathogenic bacteria on wound surface. An infection can be suspected by prolonged aching pain, unpleasant-smelling discharge, as well as increased body temperature. They can be symptoms of endometritis, salpingitis and even thrombophlebitis of the uterine vessels.
Leaving part of the fertilized egg in the uterus. Rare complication, but taking place in medical practice. It manifests itself as pain, putrefactive discharge, inflammation of the uterine tissue and requires an urgent repeat abortion.
Proliferation of placental remnants that have not been deleted. The pathology is typical for curettage in late pregnancy and is very serious. Treatment is only surgical.
In addition to early disturbances in the body that become apparent in the first weeks, there are also late complications scraping. You can expect them even years after an abortion, since they are caused by trauma to the walls of the uterus and severe hormonal imbalance in a woman's body. These include:

• Chronic inflammatory diseases of the genital area and the problems they cause with bearing a fetus in the future.
• Adhesive processes in fallopian tubes(potential risk of infertility or ectopic pregnancy due to obstruction of pipes).
• Habitual miscarriage, miscarriages due to damage to uterine tissue.
• Need for caesarean section in subsequent pregnancies, which is associated with deformation of the cervix during abortion.
• Endocrine pathologies, mastopathy, breast tumors.
• Uterine fibroids, endometrial hyperplasia, ovarian cysts.
• Disruptions in the menstrual cycle, long absence menstruation.
• Menstruation after curettage

Bleeding of the uterus is observed until the integrity of all vessels damaged during abortion is restored. It is believed that normal vaginal bleeding lasts up to 3-10 days.

Since the day of abortion in terms of the menstrual cycle is its first day, menstruation should occur 21-32 days after the operation. If their signs are not observed even after 40-45 days, you should consult a gynecologist. Amenorrhea is one of the symptoms of damage to the deep layers of the endometrium or serious hormonal imbalances.

They often become irregular. Thus, for women who have given birth before, the period full recovery a cycle can take 3-4 months, while in nulliparous women it can take up to 6-7 months. Many people also note severe pain in menstruation, or excessive profuseness. Hormonal therapy, which is prescribed only after passing the necessary tests, can help to rehabilitate faster.

Sex after scraping

Sexual relations after an instrumental abortion are prohibited for a period of 3-4 weeks. A traumatic operation leads to severe damage to the tissue of the uterus, so the vulnerability of the genital organs to infectious particles increases. Sex immediately after an abortion is strictly excluded: this can serve as an impetus for the resumption of bleeding. Ideally, you should renew sex life after the start of menstruation.

Pregnancy after curettage

Irregularity of the menstrual cycle is one of the reasons for repeated unwanted pregnancies. In this regard, careful protection after curettage is necessary. More often it comes down to barrier contraception or taking hormonal medications. Planning offspring immediately after an abortion is a rash step: the genitals have not had time to recover, and the tissues of the uterus and hormonal system are still in a depressed state for a long time, so the risk of miscarriage or premature birth very high. Optimal time for subsequent conception - six months after curettage.

Failure to conceive is a common complication of abortion, due to inflammatory diseases and spikes. Moreover, the likelihood of infertility increases with the number of operations performed. It has been established that up to half of cases of inability to have offspring are caused by abortion, so you should think carefully before deciding to have the uterus curetted.

Lifestyle after curettage

To avoid severe complications, it is worth following some rules in postoperative period:

- V winter time dress warmly, do not let your feet get cold, do not get exposed to drafts;

– strictly monitor the hygiene of the genital organs;

– limit physical exercise to avoid the risk of bleeding;

– do not swim or take a bath for at least a month;

- control general state body, especially an increase in body temperature (if you have a prolonged low-grade fever or develop a fever, consult a doctor immediately);

– visit the gynecologist at the time indicated by him;

– If you feel unwell or have persistent pain, also consult a doctor.

A qualified doctor will recommend measures for rehabilitation after curettage. Medical methods to prevent complications include antibiotic therapy, as well as instrumental examinations uterus 2 and 6 weeks after abortion. The condition of the mammary glands should also be checked within six months.

Often the gynecologist prescribes hormonal medications, vitamins, herbal medicine, physical therapy, special massage uterus. A woman should eat well and properly in order to quickly restore strength after surgical intervention. Many people who have had an abortion require increased care and attention, and even the help of a psychologist, which should not be neglected by the women themselves and their loved ones.

Medical abortion is a convenient way to interrupt a pathological or desired pregnancy in the early stages. However, if the procedure is performed incorrectly, there is a risk that fragments of the embryo will remain in the uterine cavity, which will inevitably lead to serious complications, accompanied by bleeding and severe pain.

COST OF ABORTION IN OUR CLINIC IN ST. PETERSBURG

What is an incomplete medical abortion?

Pregnancy during pharmabortion is terminated by taking special medications.

If the outcome is favorable, the fertilized egg is completely released with menstrual flow. With an incomplete abortion, the pregnancy progresses further, or complete cleansing does not occur - not all fragments of the membranes come out of the uterine cavity. In this case, the contents of the uterus are removed urgently, since the remaining biological tissues decompose, creating favorable conditions for the development of pathogenic, dangerous microflora.

In order to identify the problem in a timely manner, you need to attend an ultrasound scan at the appointed time after the procedure and then visit a gynecologist after another 2 weeks. If there is something left in the uterus, cleaning is carried out by vacuum aspiration, less often by curettage. According to statistics, the frequency of incomplete tablet abortion at up to 9 weeks is 0.4%.

Common causes of incomplete abortion

The following factors may result from the incomplete expulsion of the embryo from the uterine cavity:

• errors in the abortion procedure;
• incorrectly selected medications - often women take only one drug, forgetting about the second;
• violations in the dosage of the drug - this happens during a home abortion;
• hormonal imbalances;
• late stage of pregnancy - therefore it is necessary to undergo an ultrasound to determine the timing, and only then take abortion pills;
• inflammation;
• food poisoning, in which some of the medicine could be vomited.

Medical abortion is performed in the early stages, up to 6 weeks, exclusively under the supervision of a gynecologist. Termination of pregnancy performed in this way later increases the risk of serious complications several times.

This is why pill abortion drugs are not commercially available. Taking pills incorrectly is a direct threat to a woman’s health and life.

Symptoms of incomplete medical abortion

Signs of an incomplete abortion may appear immediately or after a few days. A woman may feel discomfort in the lower abdomen. The pain is nagging, cramping in nature, occurs acutely, taking painkillers gives a temporary effect. Unfortunately, these symptoms are often considered the norm: women think that this is how it should be after taking the pills.

Other symptoms indicate an incomplete miscarriage:

• heavy vaginal bleeding;
• heat;
• increased pain during sexual intercourse;
• chills, weakness;
• pain radiates (gives) to the sacrum and perineum.

Against the background of prolonged bleeding, dizziness appears, the pulse quickens, and sweating increases. Fragments of placental or embryonic tissue, decomposing, lead to disruption of the microflora and the proliferation of pathogenic bacteria.

Over time, the signs become more vivid, they are joined by:

• soreness in the perineal area;
• serous discharge;
• itching, burning of the genitals;
• joint weakness;
• irritability, nervousness.

During the examination, the doctor conducts instrumental diagnostics and is based on laboratory findings. A transvaginal ultrasound of the uterus is required to detect blood clots and remains of embryonic components. Blood and urine tests confirm the developing inflammatory process.

Necessary procedures

If the diagnosis incomplete abortion" is confirmed, the remains of the fetus are urgently removed. Modern medicine allows you to do this in several ways.

If the problem is detected on day 5-7, it will help drug therapy, which consists in taking drugs that provoke the rejection of pathogenic tissues.

Vacuum aspiration is prescribed when more than two weeks have passed since the abortion. The procedure is painless, short, performed under anesthesia, and involves sucking out the remains from the uterine cavity.

Surgical curettage is performed under general or local anesthesia. The operation lasts 30 minutes, after which the woman recovers from anesthesia in the hospital room. The gynecologist prescribes hormonal testing and antibacterial therapy.

Pregnancy after incomplete abortion

Medical termination of pregnancy is the safest abortion, but it also has consequences, since it is a violent intervention in the physiological process.

Women, especially those who have had an abortion more than once, should plan the desired pregnancy only after examination, coordinating the timing with the gynecologist. The body needs time to recover (at least six months).

• threat of miscarriage;
• improper attachment of the fertilized egg;
• intrauterine growth retardation.

Childbirth is accompanied by impotence, weakness, postpartum hemorrhage. IN postpartum period Infectious and septic complications often occur.

If a medical abortion goes well, it will not cause any significant health consequences.