When is it necessary to have a uterine curettage after medical abortion? Be careful in such cases

Medical abortion is the use of drugs to terminate pregnancy and is the latest development in the past 20 years. During the medical abortion process, regardless of whether the embryonic sac is seen to be discharged or not, as long as the patient has severe vaginal bleeding, uterine curettage should be performed immediately to stop the bleeding. In addition, if ultrasound examination shows residual tissue, uterine curettage is required.

1. Overview

Medical abortion, also known as drug abortion, refers to the use of Mifepristone tablets plus misoprostol to terminate early pregnancy. In recent years, it has been widely used in clinical practice and is a very popular drug for preventing early pregnancy. It can achieve artificial abortion in the early stages of pregnancy without the need for surgery, but by injection or medication. The use of drugs to terminate pregnancy and medical abortion is the latest development in the past 20 years. Currently, the commonly used drugs are mifepristone tablets (Ru 486) and prostaglandins. The former causes degeneration and necrosis of the uterine decidua and softening of the cervix, while the latter causes uterine contraction and promotes the expulsion of the embryo.

2. Reasons for the Qing Dynasty

1. Patients usually need to stay in the hospital for 4-6 hours after taking the medicine. During the observation period, regardless of whether the embryonic sac is seen to be expelled or not, as long as the patient has severe vaginal bleeding, uterine curettage should be performed immediately to stop the bleeding.

2. Situations in which a uterine curettage is required after medical abortion include: after medical abortion, although the embryonic sac is seen to be discharged, there is profuse vaginal bleeding, or the bleeding is sometimes more and sometimes less, sometimes not, for more than three weeks. Ultrasound examination shows residual tissue, and a uterine curettage is required so that the endometrium can gradually repair itself. It should be noted that since the long-term presence of pregnancy residues can cause intrauterine infection, leading to endometritis, myometritis or adnexitis, antibiotics must be used before and after curettage to prevent or treat infection.

3. The amount of vaginal bleeding after medical abortion is less. You should go to the hospital for an ultrasound examination one week later to confirm the condition of the embryo. If the embryo is not dead and continues to grow, curettage can terminate the pregnancy; if the embryo is dead but not expelled (embryonic arrest): curettage can remove the pregnancy products in the uterine cavity and prevent bleeding and infection.

Experts remind that female friends who have an unexpected pregnancy must consider their own health and choose a safe and effective abortion method. It is best not to have a medical abortion to avoid a second uterine curettage operation.