Recovery and new pregnancy after curettage during a missed pregnancy. Repeated cleaning of the uterus: when it is needed

Curettage of the uterine cavity is a procedure in which, using special tools or a vacuum system, the doctor removes the upper layers of the uterine lining. In medicine, there is a word curettage - gynecological cleaning.

Often, for such a procedure, it is necessary that the uterus opens, it is opened with the help of special tools. Curettage is usually done to diagnose the treatment of a particular gynecological disease or for other purposes.

When to do this procedure

Will have to do if pathologies on the uterus are detected

Scraping is done in cases where:

changes in the endometrium that are detected by ultrasound. When the doctor detects any formations or thickening of the endometrium. In order to establish an accurate diagnosis of the disease;
violation of the menstrual cycle. When there are abundant discharges, for a long time not stopping menstruation. When pregnancy does not occur, no pathologies have been identified. Bleeding during menopause. There are bleeding in the interval between menstruation;
pathologies were found in the uterus. On examination, the doctor revealed anomalies associated with the cervix, suspicions of malignant diseases;
miscarriage. It is prescribed by a gynecologist in order to remove the remnants that remain in the uterus, particles of the placenta. Also, the remains of the fetal egg are removed after childbirth;
frozen pregnancy. Not all pregnancies go well for every woman. There are cases of missed pregnancy, and it is necessary to do scraping;
problems with conception, infertility.

Often, cleaning is combined with hysteroscopy, it shows the uterine cavity and, if there is such a need, to carry out additional cleaning of the untouched area.

Preparation for surgery

When an ultrasound specialist determines that the fetus has no signs of life, the woman will have to undergo a scraping or cleaning procedure, which is done in case of a missed pregnancy. Usually curettage is carried out a few days before menstruation begins. This will help reduce blood loss and speed up the recovery process of the uterus after a similar procedure.

Training takes place exclusively under the supervision of specialists

In order for the operation (after all, this is a surgical intervention) to be successful, the specialist prescribes the necessary examinations to ensure your safety. You need to take a blood test, a coagulogram (an analysis that is performed to clarify blood clotting), a bacteriological smear.

Many are interested in how curettage is done during a frozen pregnancy? The embryo and its membranes will be removed. You will need written consent for the operation. On the eve of the operation, it will be necessary to refuse to eat and drink eight to twelve hours in advance. This is all done in order to safely conduct anesthesia. It is necessary to inform the doctor about taking medications (due to the disease), if any.

The operation itself - curettage during a frozen pregnancy takes place in this mode. You will be invited to the operating room, where you are located on a couch with legs (as at a gynecologist's appointment). Before anesthesia, you will be asked about allergic reactions, contraindications, those diseases that you have suffered.

The operation is usually done under general anesthesia, injected intravenously, its effect lasts from fifteen to twenty-five minutes. After injecting the drug, you fall asleep within a few seconds. You will wake up already in the ward, you will not get any sensations from the operation.

When you fall asleep, the specialist inserts a speculum into the vagina to detect the cervix. With the help of tools, it catches the neck, fixes it. Then they expand it. Then the cleansing process begins. Then all fixtures are removed. The cavity is treated with antiseptics, ice is placed on your stomach. This is done so that the uterus contracts and the bleeding of small vessels stops sooner.

Usually, a woman will sleep for several hours with ice on her stomach. After that, if you wish, you can go home or for some time you can be observed in the clinic. As a result, the whole procedure lasts about twenty minutes.

The doctor prescribes certain medications to reduce pain. Antibiotics are often prescribed to rule out infections. Physiotherapy may be prescribed. An appointment is made and further actions are already being discussed with the doctor in order to avoid unpleasant consequences from curettage during a missed pregnancy.

: Borovikova Olga

gynecologist, ultrasound doctor, geneticist

In most cases, curettage of the uterine cavity, or, in other words, cleaning, is carried out after a frozen pregnancy. There are several options for cleaning, which we will discuss later. If the procedure is not carried out in a timely manner, then this threatens the development of a bacterial infection and even the death of a woman.

Examination before scraping

After the woman is sent for a diagnostic examination. Diagnosis helps to identify the reasons why the death of the fetus occurred.

Laboratory examination methods:

An analysis is prescribed for mycoplasma, papilloma, herpes and gonorrhea.
Blood is taken to determine the female and male sex hormones.
Blood for RV, HIV and hepatitis.
PCR smear for ureaplasma.
Analysis for .

Instrumental examination methods:

Assign ultrasound diagnostics of the pelvic organs.
Genetic testing is underway.

If necessary, doctors prescribe an immunogram. Often, after a frozen pregnancy, a woman is prescribed a histological examination. Using this method, you can quickly determine the malformations directly in the fetus. As a rule, the cause of death is a violation of the genetic background, as well as the presence of a viral infection.

How to clean after a frozen pregnancy

There are several options for cleaning after a frozen pregnancy. Therefore, we consider each method separately.

Tablet cleaning

This method is often used, especially if the embryo has stopped developing before 6 weeks. At an early stage, it is more efficient and safer to clean with pharmaceuticals.

As a cleansing, doctors prescribe drugs that contain mifepristone or misoprostol. Before taking pills, you need to know the basic rules.

The day before taking the drug, do not eat fatty and heavy foods.
Exclude alcohol.

Stages of cleaning tablets:

If you take the drug Mifepristone, then its main goal is to separate the fetal egg directly from the endometrium. Non-steroidal anti-inflammatory drugs should not be taken with this drug together. Otherwise, side effects may occur.
As soon as you take the drug, after about 36 or 48 hours, the active ingredients will begin to provoke contractile activity. At this moment, a woman may feel pain, which is cramping in nature.

At this point, the drug stops. After taking on the 10th day, it is necessary to undergo an ultrasound examination in order to evaluate the effectiveness of the tablets.

This method of cleaning has both positive and negative sides. As for the positive aspects, when cleaning with tablets there is no need to resort to anesthesia, and there is no mechanical effect and there is less risk of complications.

Cons of such cleaning: expensive pills, pain may occur. Often at the time of taking the pills, they simply do not work, so you have to resort to other methods.

vacuum cleaning

This is the most gentle method of cleaning from a frozen pregnancy. The procedure can be carried out if the fading occurred no later than 7 weeks. Before vacuum cleaning, it is necessary to mentally prepare. The procedure is carried out under general anesthesia. In rare cases, local anesthesia is used.

If doctors perform the procedure under general anesthesia, then in this case the woman needs to refuse food for 12 hours.

With local anesthesia, doctors give the woman a drug 30 minutes before the procedure to help relax the cervix.

Additional rules:

Before vacuum aspiration, it is recommended to remove hair in the intimate area.
2 days before the procedure, refuse sexual contact.

In addition, for 2 days it is necessary to abandon all scented hygiene products, including intimate cosmetics, not to take any drugs, as well as various vitamins.

The main stages of vacuum cleaning:

Strip to the waist.
Lie down on a special gynecological couch or chair.
Doctors treat the genitals. As a treatment, a special antiseptic solution is used.
A special speculum is inserted into the vaginal cavity. At the time of insertion, the cervix opens.
Then the hysteroscope is inserted. The device helps to determine the length of the uterus.
Doctors then gently insert a suction tube into the uterine cavity. The tube is attached to a manual aspirator. Some clinics have an electrical device installed.

After all these activities, the removal of the concept is carried out. The moment of removal can be monitored using ultrasound diagnostics.

This method also has pros and cons. Positive aspects: no trauma to the uterine cavity. As for the cons, vacuum cleaning can lead to complications. In rare cases, an incomplete abortion is possible after the procedure.

Cleansing with acute curettage

Curettage can be done up to 12 weeks. The basic rules before the procedure remain the same. It is necessary to remove hair in the intimate area, within 12 hours before the procedure, do not eat or drink.

Stages of implementation:

Undress, lie down on a chair.
Doctors administer anesthesia.
Genital organs are treated with an antiseptic.
A mirror is inserted into the cavity.
Then doctors carefully treat the vaginal walls with an alcohol solution.

The expansion of the cervix is carried out due to the alternate introduction of cylinders. Doctors then insert a curette. Then the removal is carried out.

Dilation and evacuation method

This method is a bit like acute curettage. The procedure can be performed from 13 to 22 weeks.

Important! The dilation and evacuation method is usually performed before 16 weeks to avoid complications.

Before carrying out the procedure, follow all standard rules. After that, doctors carry out a gradual expansion of the cervical canal itself.

Additional steps:

Antiseptic treatment.
Doctors perform a paracervical blockade. If necessary, cleaning is carried out using general anesthesia.
Superimposed bullet forceps directly on the cervix.
Then the cervix is lowered down, closer to the exit from the vaginal cavity.
After that, a gynecological dilator is introduced, which is called Hegara. Additionally, a cannula is inserted into the cavity.

In the final stage, removal is carried out using abortive syringes.

The positive aspects of this method are that this method will allow you to extract the dead fetus at a later date. Of course, there are also disadvantages, after such a procedure, the percentage of complications increases.

Artificial childbirth with a missed pregnancy

Often, fetal fading occurs in the first trimester. But, there are times when fading occurs in the second trimester or in the third. Therefore, in such situations, doctors resort to artificial childbirth. In other words, they perform a small vaginal caesarean section or stimulate labor.

Hormonal stimulation

If the fetus has stopped its development for a period of 16 weeks, then the cleaning is carried out with the help of uterine contractions caused in a special way. Before the procedure, the patient is hospitalized and a diagnosis is prescribed.

Cleaning steps:

The day before artificial birth, a dilator is inserted into the cavity of the cervical canal.
Then the uterine cavity is stimulated. To do this, doctors use special injections.

After that, the fetus is expelled from the uterus on its own. Additionally, after artificial cleaning, they can resort to a vacuum - aspirator.

Positive qualities: does not require anesthesia. Negative sides: from the moment of stimulation to the extraction of the fetus, several days may pass. In addition, this method is quite painful.

Note that at the time of stimulation of contractions, doctors do not administer painkillers to a woman in order to ease the pain threshold. Therefore, it remains only to be patient.

Small caesarean section

This method is used if the condition of the woman does not allow for artificial stimulation. The operation is carried out up to 24 weeks. Before removing the fetus, an incision is made directly on the anterior abdominal wall.

Anesthesia is administered.
A catheter is inserted into the urethra.
An incision is made in the abdominal wall.
The frozen fruit is removed.
The incision is sutured.

At the final stage, a sterile bandage is applied to the incision site.

Discharge after cleaning a missed pregnancy

After the fetus fades, discharge occurs, and this is considered normal. After all, if curettage was performed, then in this case, doctors partially removed the endometrium.

After cleaning, bleeding may occur, which lasts for 3 to 4 days.

Why does brown discharge occur? In the second week after cleansing, brown discharge may occur. Such discharge should alert a woman, especially if they are plentiful.

Yellow discharge after cleaning a dead pregnancy talk about the presence of an inflammatory process in a woman. In this case, you should immediately consult a doctor and undergo the necessary treatment.

Pain after cleansing

Pain in the abdomen occurs in a woman against the background of an injury, at the time of curettage of the uterine cavity. It should be noted that if there is no discharge, but there is severe pain in the lower abdomen, then this indicates the development of complications. As a rule, in this case, there is a retention of blood in the uterine cavity.

Pain and heavy bleeding indicates a delay in parts of the fetal egg. Therefore, doctors carry out a repeated procedure, often resorting to vacuum cleaning.

A woman may experience chest pain after brushing. The pain symptom occurs against the background of a hormonal breakdown, which the woman experienced at the time of cleaning. In order to eliminate violations and pain symptoms, doctors prescribe oral contraceptives, if necessary, prescribe painkillers.

Temperature after scraping

In rare cases, after curettage of the uterine cavity, a woman's temperature rises. As a rule, the increase reaches 38 degrees.

If the temperature does not subside within a few days, you should immediately consult a doctor.

When do periods start after a missed pregnancy?

Every woman should understand that at the moment of scraping, the body suffers a shock.

The first day when scraping was carried out can be considered as the beginning of a new cycle.

The first menstruation begins only after the upper uterine layer of the woman is fully restored.

As a rule, menstruation after scraping should occur between the 28th and 35th day.

Recovery after cleansing

In order to fully recover, a woman must follow the standard rules. Eat right, get rid of bad habits, and take vitamin and mineral complexes prescribed by your doctor.

If there is a violation of the menstrual cycle, then in this case the woman is prescribed hormonal drugs.

If necessary, the patient is prescribed a course of sedative drugs, as well as tranquilizers. Such drugs are prescribed for a neuropsychiatric disorder in a woman.

It should be noted that recovery after cleaning should occur naturally. Recovery can take up to 2 months.

In the event that the woman's body has not recovered in 2 months, then doctors prescribe combined oral contraceptives.

The most common drug is Duphaston, and other analogues can also be prescribed. Duphaston must be drunk after a frozen pregnancy 2 times a day. The duration of admission should be from 11 to 25 days of the cycle.

If used incorrectly, side effects may occur.

For example:

Headache.
Nausea.
Allergic reaction on the skin like urticaria.

In more severe cases, migraine occurs and liver function is disrupted. Now consider what contraceptive drugs can be prescribed after STD. Such drugs are prescribed only if a woman has a violation of the menstrual cycle, as well as for the purpose of contraception.

For correction, a drug may be prescribed. This drug is based on estrogen and progestin.

In the normal course of menstruation, this drug can also be prescribed for the purpose of contraception. In this case, it is necessary to take Regulon from the first day of the cycle to 21 days. Then take a break for one week.

Do not take Regulon for angina pectoris.
Migraine.
epilepsy.
For severe depression.
With Gilbert's syndrome.
If there is a history of tumors.

If used incorrectly, an adverse reaction occurs. Allergies, nausea, aggravated depression are often manifested.

A cheaper option is a drug. The drug is used not only as a contraceptive, but also to restore the whole organism as a whole.

Yarina needs to be drunk for 21 days, then doctors recommend taking a break for a week.

Contraindications for use:

Do not take if you have diabetes.
With deep vein thrombosis.
With a heart attack or arterial hypertension.

As for side effects, severe nausea or an allergic reaction on the skin may occur.

Appointed extremely rarely. This drug is low-dose, refers to oral contraceptives. The active components of the drug help to suppress the process of ovulation, thereby restoring the cycle and making it more regular.

Contraindications for use:

Do not take for migraines.
With thrombosis or thromboembolism.
With severe neurological signs.

Contraindications also include diabetes mellitus and individual intolerance to the composition of the drug.

Take 1-2 capsules daily. The course is assigned on an individual basis. Note that the daily dosage of the drug varies from 200-300 mg.

When the dosage is exceeded, side effects occur. For example: dizziness, allergic reaction.

What other hormones can prescribe after a frozen pregnancy? Very often, after ST, gynecologists prescribe Metipred. Most often, it is prescribed if a woman has a high level of male sex hormones. After all, this is what can lead to the subsequent fading of the fetus.

Antibiotics after ST

Antibiotics after a missed pregnancy are prescribed to prevent the development of infectious complications. Most often, doctors prescribe the drug Ceftriaxone to women.

The daily dosage of this drug should not exceed 2 grams. Take the drug once a day. If the drug is prescribed 2 times a day, then it is necessary to take 0.5 grams.

Assign in the form of injections, the course is from 2-3 days. An overdose causes a side effect. For example: an allergic reaction like urticaria on the skin, in more severe cases, bronchospasm occurs. Often, as an adverse reaction, a woman shows signs of candidiasis. Contraindications: renal or hepatic insufficiency.

When the fetus fades, the woman stops the signs of pregnancy. But, only a gynecologist can diagnose this process.

A woman during pregnancy must carefully monitor her health.
As soon as they occur that are not characteristic of pregnancy, consult a doctor.
Before, you must undergo a thorough examination by a doctor. If there are diseases that are sexually transmitted, they must be cured.
Get rid of bad habits.
Maintain immunity.
Eat right, enrich your diet with healthy foods.
Walk more outdoors.

In addition to these rules, a woman should try to avoid stressful situations.

Consequences and complications

Almost every woman has a question, what complications can arise after cleaning during a missed pregnancy. It should be noted right away that the complications are mostly associated with the inflammatory process that occurs on the mucous membrane in the uterine cavity.

When doctors perform curettage on a woman, there is a risk of infectious agents entering the uterine cavity. Therefore, a woman develops endometritis.

Endometritis with untimely treatment can also give serious complications. Sepsis, adhesions develop, and there is also a risk of infertility. As a treatment for such an unpleasant disease, doctors prescribe long courses of antibiotics, along with vitamins and mineral complexes, to support the woman's immune system.

Additional complications include an increase in body temperature, bloody copious discharge from the genitals. As soon as these symptoms occur, you should immediately consult a doctor. Do not try to eliminate the symptoms yourself, as this can lead to serious consequences.

For a woman, fetal fading is a very serious both moral and physical stress. Therefore, in such situations, relatives should support the woman. If, after scraping, a woman is in a severe depression, then it is worth contacting a psychologist.

Now you know that there are several ways to cleanse a missed pregnancy. Which method will be used, decides only the attending physician. After all, it is necessary to take into account the duration of pregnancy, laboratory parameters, as well as the general condition of the woman.

Tablets for cleaning with a frozen pregnancy should not be used on their own. After all, they do not give a 100% guarantee. In order to avoid serious health problems, the drug should be prescribed by a gynecologist.

Women undergo the procedure of curettage of the uterus either at their own request to terminate the pregnancy or as prescribed by a doctor for any pathology for diagnostic and therapeutic purposes.

Unfortunately, in some cases, it is prescribed to undergo a second cleaning of the uterus. The cause may be bleeding from the genital tract as a result of insufficient contraction of the uterus, the accumulation of blood clots or the remains of a fetal egg in the uterine cavity, the presence of a placental polyp. All this can occur after:

miscarriage (spontaneous abortion);
(failed abortion), when the fetus stops developing and dies;
medical abortion or after, carried out at an early stage up to 6 weeks of pregnancy;
unsuccessful abortion in the early stages up to 12 weeks or in the late periods from 13 to 27 weeks strictly for medical reasons;
artificially induced premature birth, when termination of pregnancy is required in terms of more than 28 weeks and urgent delivery.

In addition, there are gynecological indications:

recurrent postmenopausal bleeding;
rarely, but still there is a repeated curettage after removal of the neoplasm.

If endometrial hyperplasia is detected, a separate diagnostic curettage of the uterus and cervical canal is normally performed, then a second cleaning is prescribed:

after 3 months if atypia is detected for control;
if a relapse occurs against the background of hormonal therapy;

How is the cleaning process going?

The procedure for curettage of the uterus is an operation lasting about 20 minutes under the influence of general intravenous anesthesia. The patient falls asleep and feels nothing. Epidural (spinal) anesthesia can also be used when the woman is conscious and does not feel the lower half of the body, but this type of anesthesia is used much less frequently. In other cases, they may be limited to local anesthesia, but the pain still remains.

Before and after the operation, the external genital organs and the vagina must be treated.
Then, using special tools, the cervix is fixed, the length of the uterus is checked and the cervical canal is expanded.
The contents of the cavity and the surface layer of the uterine mucosa are removed using a curette, hence the name - curettage; or carry out vacuum cleaning with aspiration.

Reminder to the patient after repeated cleaning of the uterus

After repeated curettage, it is important to follow the doctor's recommendations so that there are no complications and recover faster:

continue and complete the prescribed treatment (antibacterial, hormonal, hemostatic, uterine contractions and other groups of drugs);
watch for secretions from the genital tract. Normally, after the procedure, spotting gradually decreases in volume and lasts no more than 10 days;
sexual rest for at least 2 weeks, and preferably up to a month and after a follow-up examination;
do not use tampons or douche;
exclude physical activity;
you can not go to the sauna, take a hot bath.

If you experience the following complaints, you should consult a doctor to exclude or identify pathology, and carry out appropriate treatment:

body temperature above 37 degrees, general weakness, dizziness;
after a few days, pains appeared in the lower abdomen and lower back;
vaginal discharge with an unpleasant odor;
the amount of bloody discharge does not decrease or they suddenly stop;
after 1-1.5 months, the discharge did not begin, and the first menstruation may be scarce.

Consequences of repeated cleaning

Curettage of the uterus is a surgical intervention, so there may be negative consequences that occur immediately after the procedure or after some time:

inflammation of the lining of the uterus (endometritis);
perforation of the walls of the uterus during the procedure;
stenosis (narrowing) of the cervical canal of the cervix;
the formation of adhesions in the uterine cavity;
menstrual irregularities;
due to damage to the deeper layers of the uterine mucosa, which prevents the implantation of a fertilized egg in the future.

In any case, after discharge, a follow-up examination by a doctor, an ultrasound examination in dynamics and, if necessary, a colposcopy, are necessary.

For better recovery, you can take a course of physiotherapy (electrophoresis, mud therapy, acupuncture). Eat more liquids and healthy food, drink.

Vladlena Razmeritsa, obstetrician-gynecologist, specially for the site

Sometimes it happens that the fetus, instead of growing and developing normally in the mother's womb, dies. Pregnancy freezes. It is already impossible to save a child, but such a condition is dangerous for a woman, and in order to prevent negative consequences, cleaning is carried out after a frozen pregnancy. After this procedure, a certain time is needed to restore the health of a woman - as a rule, at least 3 months.

What is cleaning and how does it work

Medical cleaning is carried out in order to remove the dead embryo from the uterus. If this is not done, then the decomposition of the tissues of the deceased fetus will cause a local inflammatory reaction, and also provoke a general intoxication of the body. Depending on the period at which developmental fading occurred, doctors may choose one of the removal methods.

Medical cleaning

In this case, special drugs are used that provoke a miscarriage. This treatment is the least traumatic for the reproductive system, but this method can only be used for up to 5 weeks.

Vacuum aspiration

With the help of a special tool, the cervix is slightly opened, an extractor is inserted into the organ and its contents are sucked off. The operation is performed under local or general anesthesia. The uterine epithelium is minimally damaged during the procedure, and spotting after such an intervention does not last long (1-3 days). Vacuum aspiration is done when freezing for up to 8 weeks.

Scraping

Therapeutic curettage is performed under local or general anesthesia (the type of anesthesia is determined by the doctor after clinical and laboratory studies in preparation for the operation). The uterine endometrium is cleaned using special tools.

This surgical intervention, even carefully performed by an experienced doctor, is traumatic for the female reproductive system. The recovery process after it will take a long time, and spotting with this type of treatment can last 2-3 weeks.

Artificial childbirth

At a period of 18-28 weeks, with the help of medications, labor is artificially stimulated, and after the dead fetus comes out, curettage is carried out, as described above.

The dead embryo, after being removed from the uterus, is sent for a histological examination to identify the reasons for stopping development.

After the removal of the frozen fetus, the woman must undergo a control ultrasound.

Possible Complications

Despite the fact that surgical treatment is carried out in a hospital and in compliance with all the rules of asepsis and antisepsis, after removing a frozen embryo from a woman, the following complications may occur:

Endometritis (acute inflammatory process of damaged uterine mucosa).
Rupture of the uterine neck. Such breaks heal on their own for a long time, they can suppurate. To prevent the attachment of a secondary infection, immediate suturing of such traumatic cracks on the neck is necessary.
Incomplete removal of pieces of the fetal egg, which begin to be rejected by the woman's immune system, causing hyperthermia and severe pain. In severe cases, with untimely seeking medical help, sepsis may develop.

In order to notice signs of developing complications in time, in the first days after surgical treatment, it is necessary to carefully monitor such moments.

Body temperature

The presence of even a slight hyperthermia, even if there are signs of a cold, should serve as a reason for an additional examination.

The inflammatory process can begin in the reproductive system, and a cold will occur already due to a weakened immune system.

Allocations

Normally, the discharge will be scanty and bloody, resembling a menstrual "daub". The presence of strong bleeding or discharge with an unpleasant odor and with additional impurities to the blood will indicate the presence of a pathological process.

Pain syndrome

In the first 2 days after the extraction of the embryo, due to instrumental intervention, slight pains in the lower abdomen are possible.

But a prolonged or intense pain syndrome is a sign of the development of postoperative gynecological pathology.

Any deviation from the normal course of the recovery period should be immediately examined and treated. Timely treatment will help reduce the consequences of complications, such as the development of chronic diseases or even infertility.

Recovery of the body

To recover from a frozen pregnancy and subsequent extraction of a dead embryo, the female body will need about 3 months. It is during this time that normal menstrual flow will be established, the cycle will normalize, hCG (pregnancy hormone) will be excreted from the body. Despite the fact that 3 months are enough for recovery, doctors recommend planning a pregnancy after curettage of a missed pregnancy no earlier than 6-12 months later, to reduce the risk of re-development of this pathology.

In order to minimize the risk of fetal death in subsequent pregnancies, the following treatment is prescribed after cleaning.

Antibacterial therapy

As a prophylaxis of a secondary infection after curettage, especially if the fetal fading was not detected immediately, broad-spectrum antibiotics are prescribed.

If the patient has purulent discharge or discharge with an unpleasant odor, her drugs are selected individually, taking into account the data of clinical and laboratory studies. During this period, it is better to avoid sexual intercourse or use barrier contraceptives (condom).

Hormonal remedies

To quickly bring the female hormonal background to the pre-pregnancy state, hormones are prescribed.

More often, these are hormonal contraceptives, which not only stabilize the menstrual cycle, but also prevent unplanned pregnancy.

Psychological help

For the female psyche, which is already set for the upcoming motherhood, the loss of an unborn child is a great stress. Sometimes women need the help of a psychologist to stop feeling guilty about what happened and get rid of the fear of subsequent failures. In severe cases, at the initial stage of psychological treatment, in combination with hormonal and antibacterial therapy, antidepressants or tranquilizers are prescribed.

The risk of recurrence of pathology

There is a chance that the fetus will die in the womb with every conception. But even if this happened, the risk of repeating this situation is small. To bear and give birth to a healthy child, you must:

Plan pregnancy not earlier than six months after the previous unsuccessful attempt.
During the recovery period, pay attention to your own health, because, as a rule, a healthy child is born to a healthy mother. Perhaps the body was weakened due to a chronic illness and could not provide the embryo with the substances necessary for development.
Psychologically tune in and believe that this time everything will go well, and enjoy the feeling of upcoming motherhood. You should not plan conception if the fear of losing a child persists.

A frozen pregnancy is not a sentence, and the risk of a recurrence of the situation is minimal. It is only necessary during the recovery period after cleansing to pay careful attention to your health and psychological mood, and then there will be good chances to give birth to a healthy child.

Often requires forced curettage and full treatment. The remains of a fertilized egg are not always released in full. When and after what actions can a new pregnancy be planned after a dead one? Does scraping affect reproductive health?

Uncomplicated does not affect reproduction. In addition, a woman is able to become pregnant within a month after cleaning. However, curettage removes the upper layer of the endometrium, which injures the uterine cavity. Therefore, pregnancy cleansing is associated with serious problems of bearing.

To avoid possible complications, it is necessary to consult a gynecologist who will tell you an acceptable time frame, taking into account the condition of the woman and the reasons that prompted the cleaning.

The physiological state of a woman after cleaning

There is a theory that the miscarriage of every tenth pregnancy is inherent in nature for one reason or another. With the growth of demographic indicators, the cases of fetal death, the abnormal course of the process, also increase. To agree with such a theory or not is an individual matter, one thing is obvious: for a family that sincerely wanted to give birth to a healthy baby, it is a huge stress.

Pregnancy fading is 20% more common in economically developed countries than in other countries.

The death of a fetus is stressful not only for a woman, but also for her body. The physiological state of the patient depends on the professionalism of the doctors who performed the operation. However, no less important is the subsequent treatment of the woman, her emotional recovery.

Treatment

Each case of a desired pregnancy, which ended in fading, is considered individually. There is no need to talk about a general treatment regimen that suits absolutely all women. And there are reasons for that.

There can be several reasons for freezing, from genetics to infection, and they are all treated differently.
A huge role is played by the period at which development ceased. Most fading is diagnosed at an early stage, but it is not uncommon for the fetus to die later (starting from the 16th week).
If, after the histology of the fetus, genetic mutations were detected that led to a halt in development, then there is no treatment for the woman, as such.
women determines the threshold of acceptable medications.

The recovery period, the number and type of drugs used, the rehabilitation period - these are all indicators of an individual nature.

Metipred

Hormones for the development and maintenance of pregnancy - progesterone, prolactin, which, if deficient, are compensated by medication.

If there is a hormonal miscarriage problem, ie. a woman has an increased amount of testosterone, then Metipred is prescribed for treatment.

The appointment of Metipred is possible only according to the results of tests for hormones.

The drug stabilizes the hormonal background, especially if the malfunction is due to adrenal dysfunction. Additionally, weight control is shown, if necessary, weight loss. Taking the drug imposes a restriction on the consumption of fatty protein foods (meat), as well as a ban on alcohol and cigarettes.

Terzhinan

Terzhinan copes well with inflammation of the vagina or the mucous membrane of the birth canal. It is used in combination with antibacterial therapy, as well as against the background of taking anti-inflammatory drugs, intravenously or orally (by mouth).

Tablets of the drug are introduced into the vagina, effective against fungi and pathogenic microflora. Used for prophylaxis before childbirth and for after pregnancy fades.

The composition of Terzhinan includes nystatin and neomycin, which cope with inflammatory processes, stop the foci of infection.

Recovery

- this is a kind of failure in the work of either the mother's body, or in the development of the fetus itself. In any case, it is necessary to take all measures to restore the reproductive system of a woman. How to recover and recover will tell the attending physician.

Recovery of the body, in the normal course of the postoperative period, takes at least two months.

Correctness of actions

The goal is the normal functioning of the woman's reproductive function, as well as a healthy pregnancy in the future. The outcome of subsequent conceptions depends on how correct the restoration measures were.

Fading or abnormal development of pregnancy can be repeated if the fertilization of the egg occurred earlier than 2-3 months after the miscarriage.

For the correct recovery process, a number of actions must be performed:

curettage of the uterus from the remnants of a foreign body;
the introduction of drugs and medicines that help stop the inflammatory process;
restoration of normal microflora;
taking vitamins to maintain women's health.

Effects

If, after cleansing, an inflammatory process has begun in the body, then in the absence of timely medical care, life-threatening and health-threatening consequences can develop. In some cases, after curettage of a missed pregnancy, complete infertility is possible.

endometritis

Endometritis after curettage is a common occurrence. This is an inflammatory disease that affects the lining of the uterus.

Sometimes women can develop chronic endometritis. This complication is fraught with infertility. Therefore, it is very important to detect the disease at an early stage.

Suspicions should cause the following symptoms:

weakness and malaise;
pain in the pelvic region;
purulent vaginal discharge;
an increase in temperature to subfebrile (37.1 - 38.0 ° C) and high (up to 40 ° C) values.

Hematometer

The hematometer develops against the background of poor removal of blood from the body of the uterus after. Simply put, all the clots, accumulating inside, stretch the uterine cavity and provoke severe pain, similar to labor pains. And since the blood is a nutrient medium for pathogenic microorganisms, the prolonged presence of an abundant accumulation of secretions leads to the development of an inflammatory process. As a result, the inner layers of the uterus are destroyed.

In 90% of cases, a hematometer after curettage of a missed pregnancy is accompanied by high fever and acute unbearable pain in the abdomen.

Temperature

An increase in temperature in women after curettage refers to postoperative complications that are extremely life-threatening.

This phenomenon occurs against the background of the formation of inflammation in the uterus. The outcome of treatment depends on how old this process is. Often, with advanced forms of endometritis or hematomas, removal of the entire uterus is required. When the temperature rises, you need to consult a doctor and tell how long it has been holding.

blood clots

The removal of blood clots immediately after cleansing is normal. So the uterus is cleared of the remnants of the placenta or fetal egg. The duration of the discharge should not exceed three days. As a rule, all blood clots come out on the first day. Further, the discharge becomes less abundant. How much blood flows depends on the individual characteristics of each woman.

Histology

Histological today is carried out both according to the testimony of the doctor, and at the request of the patient. If a woman during gestation did not have tumor processes, did not suffer from oncological diseases, and there are no cases of gene mutation in the family, then histology is used as an additional research method. It helps to determine the cause of pregnancy fading.

Oxytocin

Oxytocin is a hormone that is produced in women both during pregnancy and during childbirth. Without this component, the natural birth of a baby is impossible.

Since this is a forced measure designed to cleanse the body of fetal masses, to facilitate this process, it will be necessary to introduce an additional portion of oxytocin, which increases the contractility of the uterus, thereby reducing the risk of inflammation.

Repeat cleaning

If blood clots remain in the body of the uterus that did not come out, and there are also symptoms of hematometers, then a decision is made to re-curettage. Without fail, a woman is given anesthesia, since the inflammatory process increases pain.

Reasons why you need to repeat scraping:

the presence of blood in the uterine cavity;
temperature rise;
pain on palpation of the abdomen;
ultrasound shows the remnants of tissues in the uterine cavity;
a woman experiences pain that grows;
profuse discharge with a putrid odor, having a green or dark brown color.

In a woman with a gestational age of more than 14 weeks, if the placenta is attached to the lower part of the uterus, the risk of complications after curettage is 40% higher.

Planning for a child after surgery

Every woman who wanted and planned pregnancy, after the death of the fetus, is in a state of mental stress. However, the first desire is to conceive a child as soon as possible. Such a reckless desire risks turning into a repeated miscarriage.

Planning for freezing and cleansing can only be carried out if the body is fully restored. The uterus is ready for this process after the second month (as soon as menstruation starts). However, the body has no reserves to endure such an early pregnancy, too short a period has passed after curettage.

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