How many days is normal for abdominal pain after uterine curettage?

Nowadays, many people go to the hospital for uterine curettage due to unexpected pregnancy. At the beginning of the uterine curettage, there may be lower abdominal pain because of certain damage to the uterus and lower body, but it will disappear in about a week. If the pain lasts for more than a week and there are signs of severe pain and prolonged bleeding, you need to be particularly careful and pay attention to it.

Postoperative abdominal pain may be caused by several reasons:

(1) Incomplete abortion: Artificial abortion procedures sometimes fail. Incomplete abortion means that the chorionic and decidual tissue in the uterine cavity cannot be completely removed during surgery. After the operation, the uterus undergoes paroxysmal contractions in order to expel the remaining embryonic tissue from the uterus. At this time, the patient has paroxysmal attacks of abdominal pain, which are unbearable, and there is increased vaginal bleeding, which is bright red in color and contains large blood clots. The abdominal pain is relieved after the blood clots are discharged, and the attacks recur repeatedly. When an incomplete miscarriage occurs, a curettage is usually required to scrape out the remaining embryonic tissue in the uterine cavity, and the abdominal pain will disappear naturally. Strengthen anti-inflammatory treatment after surgery to prevent infection.

(2) Postoperative infection: This is one of the most common short-term complications of artificial abortion surgery. Postoperative infection often occurs within two weeks after surgery. It can be caused directly by the surgical operation or by the patient's failure to pay attention to hygiene after surgery, such as having sexual intercourse, swimming, etc. It usually leads to acute pelvic inflammatory disease, with severe abdominal pain that is persistent and may worsen in paroxysmal forms, accompanied by fever, chills, vaginal bleeding that is bright red, has a fishy odor, or is mixed with yellow discharge. During physical examination, the patient has abdominal pain that is resistant to pressure, tenderness, and rebound tenderness; gynecological examination shows cervical motion tenderness, uterine body tenderness, and both adnexa may have flake-like or cord-like thickening with obvious tenderness. If chronic pelvic inflammatory disease occurs, there will be dull abdominal pain, a small amount of vaginal bleeding, an odor, and yellow discharge. If a postoperative infection occurs, whether acute or chronic, adequate antibiotic treatment must be given. A combination of Chinese and Western medicine can also be used to ensure thorough treatment.

(3) Uterine perforation: This is a very serious complication that may occur during artificial abortion surgery. Most patients experience sudden and severe abdominal pain during perforation, but a small number of people may not feel any obvious pain. The abdominal pain caused by uterine perforation is continuous, with a small amount of vaginal bleeding. If combined with internal bleeding, it may cause peritoneal irritation signs: abdominal pain that is resistant to pressure, tenderness, and rebound pain. If the perforation is small and there is no damage to internal organs such as the bladder and rectum, and there is no internal bleeding, conservative treatment can be used: the patient should rest in bed; oxytocin 10 units should be injected intramuscularly or added to glucose solution and dripped intravenously, 2 to 3 times a day; at the same time, sufficient antibiotics should be given to prevent infection; changes in body temperature, blood pressure, respiration and pulse should be closely observed. If there is still residual tissue in the uterine cavity, uterine curettage can be performed after the condition has improved. If the uterine perforation is large or is accompanied by damage to internal organs, or if there are signs of internal bleeding, surgical treatment is required.

Uterine perforation is rare, but it is more likely to occur in women who have an excessively tilted uterus or who become pregnant again within one year of a caesarean section, or who have undergone multiple abortions.

(4) Intrauterine hemorrhage: This usually occurs within a few hours after surgery. The patient suffers from unbearable abdominal pain, as if cut by a knife, and a small amount of blood and fluid flows out of the vagina. Gynecological examination reveals that the uterus is significantly enlarged, soft, and tender. At this time, immediate curettage is needed to clear the blood in the uterine cavity, and oxytocin and antibiotics should be given.