I had a miscarriage one month into my pregnancy. Do I need a uterine curettage?

Many people cannot tell the difference between spontaneous abortion and surgical abortion. Spontaneous abortion is threatened abortion, which can be divided into many types and are caused by different reasons. So, does a uterine curettage surgery need to be performed if a miscarriage occurs one month into the pregnancy? Because some types of miscarriage are difficult to completely eliminate, a uterine curettage surgery is usually required to eliminate the residual substances in the body. Next, let’s take a closer look at the types of spontaneous abortion, and then find out whether this type of spontaneous abortion requires uterine curettage.

1. Threatened abortion: The specific manifestation of threatened abortion is a small amount of vaginal bleeding before 8 weeks of pregnancy, often followed by paroxysmal lower abdominal pain or low back pain. Gynecological examination showed that the cervix was not dilated, the fetal membranes were not ruptured, the pregnancy substances had not been discharged, and the size of the uterus was consistent with the number of weeks of amenorrhea. After rest and treatment, some patients recovered. If vaginal bleeding increases or lower abdominal pain worsens, miscarriage may become inevitable. During the treatment period, luteal copper therapy can be used. During the treatment period, observe the patient's symptoms and test results, and perform color Doppler ultrasound examinations when necessary to confirm the baby's development status. Before tocolysis treatment, ectopic pregnancy should be ruled out first. Generally, the spontaneous abortion response in this situation is dominated by tocolysis.

2. Inevitable miscarriage: To put it bluntly, inevitable dystocia means that dystocia cannot be prevented. Generally, inevitable miscarriage develops from threatened abortion. At this time, vaginal bleeding increases, paroxysmal lower abdominal pain intensifies, or vaginal discharge (amniotic fluid ruptures) occurs. Sometimes it can be seen that the test tube embryo tissue or gestational sac is blocked inside the cervical cavity, and the size of the uterus is consistent with the number of weeks of amenorrhea or slightly smaller. At this time, the uterine contractions gradually intensify, and the pregnancy tissue may be partially or completely discharged, leading to incomplete or complete miscarriage. Generally, this kind of inevitable miscarriage requires uterine curettage to clean the body's waste.

3. Incomplete miscarriage: It means that part of the pregnancy substance has been discharged from the body, and part of it remains in the uterine cavity, resulting in the development of inevitable miscarriage. Because some pregnancy substances remain in the uterine cavity, uterine contractions are affected, resulting in continuous abnormal uterine bleeding and even hemorrhagic shock due to excessive bleeding. Once the diagnosis is made, the test tube embryos and embryonic tissue should be completely expelled as soon as possible. In the event of inevitable miscarriage or incomplete miscarriage in early pregnancy, vacuum aspiration should be performed immediately to eliminate it.

4. Complete miscarriage: Complete miscarriage is regarded as the more ideal type of miscarriage among these types of spontaneous abortion. Complete miscarriage means that all pregnancy substances have been discharged, vaginal bleeding gradually stops, and abdominal pain gradually subsides. Gynecological examination showed that the cervix was closed and the uterus was close to normal size. Generally, when observing a complete miscarriage, if there is no infection, no special treatment is usually required, but color Doppler ultrasound can be used to confirm the presence of residues in the uterine cavity.