The difference between medical abortion and surgical abortion

If some women have an unexpected pregnancy, they may choose to have an abortion directly. Abortion can be divided into two types. The first is medical abortion, and the second is artificial abortion. Medical abortion may require uterine curettage, and artificial abortion must have uterine curettage. If the medical abortion is not clean, uterine curettage is required. What is the difference between medical abortion and surgical abortion? Let’s analyze this issue carefully so that people can understand it.

The difference between curettage and abortion

On the surface, curettage and abortion seem to be the same thing, but in fact, the two are different, and the techniques they use are also different. The differences between curettage and abortion are:

1. Curettage

A procedure to scrape the lining of the uterus or the contents of the uterus. This is a minor surgery commonly performed in obstetrics and gynecology and is one of the methods of artificial abortion. It is divided into two categories: diagnostic curettage (abbreviated as DCT) and therapeutic curettage.

(1) Diagnostic curettage is divided into general diagnostic curettage and segmental diagnostic curettage.

General diagnostic curettage is suitable for endocrine abnormalities, which require understanding of endometrial changes and responses to sex hormones, the presence or absence of ovulation, the presence or absence of tuberculosis, etc. Segmented diagnostic curettage refers to the operation of first scraping the cervical canal and then the uterine cavity. The scrapings are sent for pathological examination separately. It is suitable for diagnosing cervical cancer, endometrial cancer and other uterine malignancies, and can understand the range of the cancer.

(2) Therapeutic curettage can be divided into suction curettage and forceps curettage.

Suction curettage is the use of a negative pressure suction tube to suck out the contents of the uterine cavity, while forceps curettage is the use of an oval forceps to remove the contents of the uterine cavity, followed by curettage. The indications for therapeutic curettage include: those who want to terminate the pregnancy in early pregnancy, suction curettage within 3 months of pregnancy, forceps curettage to remove residual materials in the uterine cavity after 3 months and after induced abortion; those who need to empty the uterine cavity for incomplete abortion, inevitable abortion, missed abortion, retained placenta, hydatidiform mole, etc.

2. Abortion

Artificial abortion is also called flow. It refers to the termination of pregnancy by surgical means, also known as "artificial" termination of pregnancy. Surgical methods include vacuum aspiration and curettage. Vacuum aspiration is to use a hollow straw to enter the uterine cavity and use negative pressure to suck out the embryonic tissue in the uterus, while curettage is to use oval forceps to clamp out large pieces of embryonic tissue in the uterus. Abortion can be performed before 14 weeks of pregnancy.

Which is better, curettage or abortion?

The most common factors that can cause endometrial damage clinically include abortion, curettage, manual placental removal, polyp removal, myoma removal, reproductive system tuberculosis, etc. Among them, pregnancy-related intrauterine operations such as abortion and curettage are currently the most common destructive factors of endometrial desertification. Therefore, curettage and abortion should be avoided as much as possible.

1. Curettage

During the curettage process, the doctor cannot see what is inside, so it may cause serious manipulation of the uterus and even lead to infertility. It is understood that although infertility caused by curettage can be treated, the results are not satisfactory. The success rate of in vitro fertilization is less than 40% at best, and it is expensive. Moreover, even if the IVF is successful, it may still cause miscarriage or ectopic pregnancy due to endometrial lesions.

2. Abortion

Abortion can easily cause damage to the endometrium and lead to intrauterine adhesions, that is, "desertification" of the endometrium. The currently common painless abortion only avoids physical pain, but it will still cause damage to the uterus. Moreover, since the patient no longer feels pain, it is easy for the doctor to use too much force during the curettage, causing further damage to the uterus. "Painless" does not mean "harmless". The trauma it causes to the body is no different from traditional abortion, and it also increases the risk of anesthesia.

How to have an abortion safely

1. Confirm pregnancy. Based on the history of amenorrhea, a positive pregnancy test can generally be diagnosed as pregnancy, but trophoblastic diseases such as ectopic pregnancy and hydatidiform mole must be ruled out. If an ultrasound shows a gestational sac in the uterus 45 days after menstruation, it can be confirmed as an intrauterine pregnancy; if there is no gestational sac in the uterus but there is one outside the uterus, it can be diagnosed as an ectopic pregnancy; if there is no gestational sac in the uterus but there is a snowflake-like shadow, it can be considered as a hydatidiform mole. Abortion can only be performed if intrauterine pregnancy is confirmed. Some rural hospitals have poor conditions and no B-ultrasound facilities, so the scrapings must be carefully examined. Only when an embryo or villi are seen in the scrapings can it be confirmed as an intrauterine pregnancy; if not, the possibility of ectopic pregnancy must be considered.

2. Use surgery or drugs to remove the embryo from the uterus. This is a key step. There are many surgical methods. The most commonly used methods are painless abortion, micro-tube painless abortion and visual painless abortion, which are suitable for early pregnancy within 3 months. Especially those who are 1.5 to 2 months pregnant. Painless abortion puts the patient into anesthesia, and the patient wakes up to find that the operation is over. Its advantages are: strong visibility. Since the operation is performed under the guidance and monitoring of visual technology, the doctor can see the situation in the uterine cavity at a glance, and can accurately and quickly remove the gestational sac without damaging normal tissues. The operation can be completed safely in a short time. It can effectively avoid the occurrence of complications, such as uterine perforation, incomplete aspiration, missed aspiration, abortion syndrome, etc. caused by tension, fear, restlessness and struggle in traditional abortion operations. The operation can be easily completed while sleeping.

3. There are two types of medical abortion, one is for early pregnancy and the other is for late pregnancy. If a woman is less than 49 days pregnant and uses medical abortion for early pregnancy, there may be heavy bleeding, residual blood, repeated curettage, a long time consumption and prolonged bleeding after abortion, so it is not the first choice. Patients with glaucoma and cardiovascular disease should avoid medical abortion as much as possible. The second is mid-pregnancy, that is, 3-5 months of pregnancy, the drug can be injected into the amniotic cavity to induce uterine contractions in the pregnant woman and expel the fetus. Since the placenta is sometimes not completely expelled, curettage is often required. This should be noted.

4. Postoperative recovery. If this period is not handled properly, it may cause serious consequences. Although miscarriage is a "short confinement month", it should be recuperated in the same way as a full-term delivery "long confinement month". You should eat nutritious and easily digestible foods such as eggs, milk, ribs, chicken, and fish. It is forbidden to wash your hair, bathe, wash your hands, or wash clothes and vegetables with cold water, otherwise the stimulation of cold water may induce arthritis, leaving behind pain in the joints and muscles of the cold affected parts.

5. Pay special attention to hygiene after the operation, change your underwear frequently, wash your vulva daily, and change and disinfect toilet paper frequently. Those with bleeding are absolutely prohibited from douches or sitz baths to avoid ascending infection. Sexual intercourse is prohibited within 4 weeks after the operation. After resuming life, you should adhere to contraception.

The best time to have an abortion

The best time to have an abortion is within 70 days of pregnancy, and the risk is lowest within 35-45 days because the fetus has not yet formed and the uterus has a thick uterine muscle wall, making it easy to suck out the embryo. The operation is short, with less blood loss, and the body recovers fairly quickly after an abortion. There are some disadvantages for those who do it too early or too late.

If an early abortion is performed, the embryo is small and it is not easy to suction out the tissue during surgery. And it's not easy to clean. If an abortion is performed too late (more than 3 months of pregnancy), the fetus's limbs have grown, and it is not easy to suck out the bones. The cervix must be dilated again to clamp out various parts of the body, or even a curettage may be needed. This not only prolongs the operation time and increases the amount of bleeding, but also makes the uterus vulnerable to damage, which is extremely harmful. If an abortion is performed within 2 and a half months of amenorrhea, the connection between the embryo and the uterus is not very close, the size is smaller, the operation is simple, the bleeding is less, and the pregnant woman is safer.

Note:

1. You must stay in bed for 1-2 hours for observation after the operation and cannot leave the abortion operating room immediately after the operation. If you do not feel any obvious discomfort and your abdominal pain is not obvious, go home and rest after consulting your doctor.

2. It is best to rest for half a month after the operation. During the rest period, you should strengthen your nutrition and avoid heavy physical labor or strenuous exercise to avoid complications such as excessive uterine bleeding and uterine prolapse.

3. You cannot take a bath in the tub for two weeks after the operation, and sexual intercourse is strictly prohibited within one month. You can use warm water to wash the vulva every day to keep it clean and effectively prevent postoperative infection.

4. Pay close attention to changes in your body during the recovery process. If you find any of the following abnormalities, you must go to the hospital for follow-up and treatment in time.

(1) Pregnancy reactions persist.

(2) Vaginal bleeding that exceeds normal menstrual flow.

(3) Vaginal bleeding lasts for more than one week.

(4) Lower abdominal pain accompanied by fever, fatigue, etc.

(5) Increased vaginal discharge with an unusual odor.

5. When you start having sex after surgery, you must take adequate contraceptive measures and avoid unprotected sex to avoid getting pregnant again in a short period of time.