Is 16mm left after medical abortion considered large?

Medical abortion is a method of abortion chosen by many people, but it also has great risks. The most common is abortion failure. Many people will go to the hospital for examination after medical abortion to see if there is any residue. Some people will find that their residue is 16mm. Usually many people are not very clear what this means, but in fact this is a phenomenon of incomplete medical abortion, which poses a great threat to the female body and needs to be resolved in time.

The current situation is considered to be incomplete medical abortion. It is recommended to go to a regular hospital for uterine cleaning treatment in time to prevent infection and bleeding.

Curettage is also known as dilation and curettage, which is the most commonly used method for early induced abortion. Although curettage does not require surgery, it is also a gynecological surgery and must be performed under strict disinfection. The operation is divided into two steps. The first step is to dilate the cervix to a sufficient size, and the second step is to use a curette to extend into the uterine cavity and scrape out the embryo. The longer the pregnancy lasts, the larger the fetus will be. At this time, the cervix needs to be dilated to the maximum limit to scrape out the fetus, so scraping the uterus becomes more difficult. At the same time, the longer the pregnancy lasts, the softer the uterus will become, and the chance of piercing the uterus during surgery will naturally increase.

Operation

Choose your timing

Once incomplete abortion, delayed abortion, or hydatidiform mole is diagnosed, uterine curettage can be performed if there are no special contraindications (including visceral diseases such as heart and lung, blood diseases, infections, etc.); if artificial termination of pregnancy is desired, it should be performed within 12 weeks of pregnancy.

Technical steps

1. Body position: lithotomy position.

2. Rinse and disinfect the vulva and vagina routinely.

3. Use cervical clamp to fix the upper lip of the cervix during uterine exploration. Send the probe along the direction of the uterine body to the fundus of the uterus to understand the size of the uterus.

4. Dilate the cervix Use a cervical dilator to dilate the cervical canal until the intrauterine suction device can pass through it.

5. During uterine curettage, insert the uterine suction device into the uterine cavity without negative pressure. Then maintain negative pressure and perform repeated scraping and suction, being gentle throughout the entire process. If the suction tip is blocked by tissue during suction, the tissue should be quickly removed before continuing suction. If there are no conditions for suction uterus, curettage and dilatation can be performed.

When suctioning the uterus, pay special attention to the uterine corners and fundus on both sides. If you feel there is still tissue, scrape it with a curette. If you feel that the uterine wall has become rough and observe bloody foam in the suction bottle, and the uterus is significantly shrunk during examination, it means that the uterus has been emptied and the operation can be ended.

Postoperative care

1. Tissue examination: Send the scrapings for pathological examination.

2. To prevent infection, take oral antibiotics for 3 to 5 days.

3. No bathing in the tub and no sexual intercourse: No bathing in the tub for 14 days and no sexual intercourse for 30 days.

complication

1. Cervical laceration is common in infertile women and usually occurs on both sides of the cervix. For such patients, the operation should be gentle. Small lacerations can be blocked with iodine gauze to stop bleeding; larger lacerations should be sutured under direct vision to stop bleeding. If vaginal hemostasis is ineffective, a laparotomy is required to find the bleeding blood vessels and ligate the bleeding. Occasionally, a hysterectomy is required.

2. Uterine perforation Pregnancy and tumors (such as hydatidiform mole) can make the uterine wall fragile, which can easily cause uterine perforation during curettage. For uterine perforation with less bleeding, conservative treatments such as anti-inflammatory and hemostatic treatments can be used; if the perforation is large and complicated by heavy bleeding, laparotomy is required to stop bleeding, repair the perforation wound, or perform a hysterectomy.

3. Adequate preoperative preparation, strict aseptic operation, and preventive antibiotic treatment after surgery can reduce the occurrence of infection.

4. Uterine cavity adhesions may occur if the scraping is excessive during uterine cleaning, with consequences such as infertility, miscarriage, amenorrhea, dysmenorrhea, etc. Adhesions can be separated under hysteroscopy.