✓ Curettage after an abortion

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Il curettage it consists of a small operation, done under general anesthesia, to remove the product of conception. Let us find out more.

What is curettage

The so-called curettage it is a brief intervention for the removal of the product of conception: it is done in deep sedation and lasts a few minutes. We return home in the day. In fact, the more correct expression is emptying and revision of the uterine cavity.

"In the gynecological field, curettage is a term that is used properly when a biopsy of the endometrium - the lining of the uterus - is needed to diagnose any pathologies or in case of particularly abundant flow, which does not respond to common pharmacological treatments" explains Ferdinando, Head of the Delivery Room of the UO of Gynecology and Obstetrics of the San Raffaele Hospital in our city.

How scraping is done

Lo uterine emptying it is done on a day hospital basis, in deep drug sedation (a kind of general anesthesia, but without intubation) and lasts about 10-15 minutes.

If the gestational period is not very advanced, the ovular material is removed with a suction cannula connected to a special vacuum pump, after which it is checked ultrasonically that there are no residues left.

If the pregnancy has exceeded 9-10 weeks, they are given at first vaginal prostaglandins, which, by dilating the cervical canal and stimulating uterine contractions, could lead to aspontaneous expulsion; if this does not happen, surgical excision is done.

After uterine revision, you return home within the day, unless fever or other complications appear, which are however infrequent. In the following days, you continue to have increasingly mild blood loss, which subsides in 7-10 days.

If the gestational age is early, wait a few days before taking action, because there could be a spontaneous expulsion.

If the spontaneous abortion occurred early, within 8-9 weeks, the gynecologist generally advises not to carry out the revision immediately, but also to wait up to 2-3 weeks, because in a good percentage of cases there is a spontaneous expulsion of the embryo. If this does not happen or if the woman does not tolerate such a long wait, it is decided for the surgical revision.

The use of misoprostol for the 'domestic' expulsion of the abortive product

For some years now, the use of a misoprostol-based drug has spread in many foreign countries to cause the 'do-it-yourself' expulsion of the product of conception. Misoprostol is a synthetic prostaglandin that prevents gastric ulcers induced by the use of non-steroidal anti-inflammatory drugs (NSAIDs), but is also capable of causing uterine contractions and therefore of promoting the expulsion of the embryo in the event of abortion. In Del Paese, misoprostol has been approved by the Ministry of Health only for the prevention of gastric ulcers, however it can also be used, under its own responsibility, to expel the abortion product before the planned hospitalization for curettage. However, he warns Dr. : "Women should not independently manage such an event, which in any case involves bleeding, pain and other possible side effects, as well as considerable emotional involvement, especially if the pregnancy was much desired".

Read also: Getting pregnant after a miscarriage

Control of beta hCG after uterine revision

After about 20 days from uterine emptying, even if the expulsion occurred spontaneously, it is good to check the Beta hCG values, to verify that they have completely cleared up and that therefore the hormonal activity linked to pregnancy has completely ceased.

(Original article dated March 2022)

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