Removing clots after childbirth using a vacuum. Should you be afraid of cleaning the uterus - the nuances of the procedure

One of the serious complications on the way to bearing a child is frozen pregnancy. This term refers to the intrauterine death of the embryo, and in later stages - the fetus. This is always the most severe psychological trauma for a woman expecting a child.

Reasons for termination of pregnancy

The causes of fading are varied and not in all cases can they be accurately determined, even through a comprehensive examination. The most common ones include:

• Chromosomal abnormalities.
• Rhesus conflict.
• Reception medications in the earliest stages, when pregnancy is not yet known.
• Infectious diseases (influenza, ARVI, rubella), sexually transmitted infections.
• Hormone imbalance.
• Autoimmune diseases (antiphospholipid syndrome).
• Stressful situations, excessive physical exercise.
• Environmental factors bad habits, unfavorable working conditions.
• Anatomical abnormalities of the uterus.

Fading in the early stages can result in spontaneous miscarriage, as a result of which the embryo that has lost its viability is rejected and leaves the uterus naturally. But more often it is necessary to perform curettage during a frozen pregnancy.

In some cases, less traumatic procedures are indicated. In the early stages, it is fashionable to limit medications or perform vacuum aspiration. The doctor selects tactics for treatment after a frozen pregnancy individually, depending on the period and health of the woman. In later stages, artificial birth is performed.

Signs of fetal death

Making such a diagnosis destroys all the bright dreams of the expectant mother. Losing a long-awaited child is difficult at any stage, especially at later stages, when future mommy I already felt the movements of my child, and suddenly the joy of waiting for a miracle is cut short by such a diagnosis. Psychological support of a woman by a doctor and loved ones is very important.

The doctor, for his part, must give her hope for the future, explaining that nature itself rejects a non-viable fetus, and that she will definitely give birth healthy child, will experience the happiness of motherhood in the future.

What symptoms and signs should alert a woman and bring her to see a doctor? In some cases, especially in the later stages, early alarm and prompt contact with a specialist can help save the child and maintain the pregnancy. Main manifestations:

• Instant disappearance of toxicosis.
• Changes in the mammary glands, return to their previous volume.
• Sometimes present nagging pain lower abdomen.
• Spotting is possible.
• Basal temperature decreases, as before pregnancy.
• If the frozen fetus does not cause symptoms or reactions and is not rejected by the uterine cavity for a long time, symptoms of intoxication appear: sharp pains, heat, weakness, pallor of the skin.
• In the later stages, fetal movements stop, pain is noted in the groin area And lumbar region, nausea, deterioration.

If alarming signs such as pain, bleeding and fever occur, urgent consultation with a gynecologist is necessary. Diagnosis is confirmed by ultrasound and hCG levels ( human chorionic gonadotropin person) in the blood.

It happens that women do not notice freezing, and it is discovered by a doctor during a routine examination.

Health care

If spontaneous miscarriage did not happen, and the deadlines do not allow us to limit medicinal removal frozen embryo from the uterus or perform vacuum aspiration, an operation is performed - curettage after a frozen pregnancy. The procedure is performed under general anesthesia (if there are no contraindications) in a hospital setting under ultrasound guidance. To avoid serious complications, it is necessary to repeat ultrasonography 10–14 days after surgery.

Curettage during a frozen pregnancy attempt (cleaning) is by far the most common manipulation in such cases. This is the instrumental removal of a frozen embryo and the mucous layer of the endometrium from the uterine cavity, mechanical surgical cleaning.

When a frozen pregnancy is confirmed, treatment must begin with this procedure. There are also contraindications:

• Acute inflammatory processes of the genital tract.
• Somatic diseases in the acute stage.
• Bacterial and viral infections in the acute stage.

If cleaning is not carried out urgently, for health reasons in a state of intoxication, the patient is prescribed treatment concomitant diseases, an anesthesiologist talks to her about contraindications to general anesthesia. Recruiting necessary tests, take an ECG.

Vacuum extraction technique

VEP is used as an abbreviation. Freezing is one of the indications for prescribing such a procedure for cephalic presentation. The main contraindication is a period not earlier than 36 weeks and a fetal weight of at least 2500 grams.

The device consists of several components, the most important are:

• Plastic cup with attached cable.
• Manual suction.
• Pressure indicator.
• Vacuum release button.

To carry out the manipulation, the woman is positioned on the birthing table with her knees bent and her hips apart. The calyx is inserted into the internal genital tract and applied to the fetal head. By manual suction, negative pressure is created in the cavity of the cup, and then traction (pulling movements) are made with the hands using the cable, aimed at removing the fetus from the uterine cavity and pelvis.

Despite the apparent simplicity, this procedure requires good skills from the gynecologist, as additional dissection of the perineum may be required.

Often you have to refuse to continue the manipulation right in the middle of it. Then they move on to other methods of cleansing the uterine cavity.

Surgical technique

The operation, if curettage is indicated during a frozen pregnancy, is performed in a hospital. When the time for cleaning is appointed, a woman, especially a woman who has previously nulliparous, if necessary, undergoes a soft opening of the cervix using kelp sticks in order to injure the cervix less. The day before she eats light dinner, before curettage, a cleansing enema is performed, the woman takes a shower and shaved the genital area. The procedure for curettage of the uterus is carried out on an empty stomach.

Everything happens according to the algorithm worked out by gynecologists. The manipulation is performed in the operating room on a gynecological chair using surgical instruments. An anesthesiologist administers anesthesia. External and accessible internal genitalia are treated. The cervix is ​​torn off with special dilators, and the gynecologist surgeon uses a curette (metal loop) to remove the frozen fetus and inner shell uterus

During cleaning, the woman does not feel pain. Additionally, hemostatic and uterine contracting drugs are administered. The duration of the operation is 15–20 minutes.

• Antibacterial therapy.
• If necessary, hormone therapy or prescription hormonal contraceptives for up to 3 months.
• Sexual abstinence for a month until complete healing.
• Mandatory repeat ultrasound after curettage.

You can plan your next pregnancy no earlier than six months after the intervention, unless there are other health problems. During this time, it is necessary to conduct an examination to determine the causes of the fading. After cleaning, the material taken from the uterus is sent for histology, which sometimes helps to find out the cause of the incident.

Possible complications

Curettage itself is a procedure often practiced by gynecologists, but it is an operation and surgical intervention in the body. Consequences surgical intervention may affect later life And reproductive function women, so you need to carefully monitor your condition and, if necessary, seek help from a specialist in time.

The most common complications:

• Inflammatory diseases, in particular endometritis, occur when an infectious agent comes into contact with the wound surface.
• Bleeding: primary (during surgery), and secondary - immediately after it or after some time due to remnants of unremoved tissue, insufficient contractility of the uterus or disorders of blood clotting factors.
• Perforation of the uterine walls. Rare, but dangerous complication, the consequences of which are solved by abdominal intervention, occurs with anomalies in the development of the uterine body (bicornuate, saddle-shaped) and deformations due to diseases (myomatous nodes).
• Adhesive processes (synechia), which subsequently lead to infertility.
• Incomplete removal of membranes of the fertilized egg.

In the postoperative period, you should follow all the doctor’s instructions and repeat ultrasound monitoring. This will help avoid many complications. Normally, the temperature rises on the first day and for 3 days after surgery to 37–37.7 degrees. Bloody discharge lasts from several days to 2 weeks; it should not be very abundant or have an unpleasant odor. Heavy discharge They say it's bleeding.

After the operation, pain is possible, but the doctor, as a rule, prescribes painkillers and anti-inflammatory drugs or vaginal and rectal suppositories. Menstrual flow can occur either after 2 weeks or after 6 weeks.

An increase in temperature to high levels a few days after surgery indicates an inflammatory process and is alarm signal. There should be no sudden increase in pain or worsening general condition, resumption of bleeding, unpleasant odor and uncharacteristic color. Bloody discharge of great intensity and lasting more than 2 weeks is a sign of bleeding.

Pay close attention to yourself in the postoperative period - this will help prevent negative consequences.

If repeated ultrasound and the clinical picture indicate incomplete removal of the membranes, repeated curettage of the uterine cavity is prescribed.

Psychological aspect

Having gone through everything healing procedures, the woman is depressed psychological state, no matter how strong, smart and strong-willed she may be. During this period, she needs powerful support, positive emotions and an attitude for the future. If loved ones cannot provide sufficient support, the doctor may recommend the help of a professional psychologist.

A frozen pregnancy is not the woman’s fault; very often it is impossible to find out the cause when in full health. She must believe that, despite all the difficulties, she will be able to bear and give birth to a healthy child.

Collapse

Cleaning the uterus is a common procedure in gynecology, which helps get rid of pathological endometrium. various methods. One of these methods is vacuum cleaning of the uterus, which is considered low-traumatic and easily tolerated. The features of this procedure and indications for it are described in this material.

Definition

Vacuum cleaning is carried out to remove all its contents from the uterine cavity. The intervention is performed using a special device, the working part of which is inserted into the uterus through the cervix. The doctor then controls the machine and creates a vacuum. Under the influence of negative pressure, all the pathological contents of the cavity end up in the tube of the device. After this, the vacuum is broken, and the device, along with all the pathological contents that have entered it, is removed from the cervix.

This method is considered multifunctional, because it is equally effective regardless of what exactly needs to be removed from the uterus (this can be, for example, gestational products, or pathological contents formed as a result of any disease). The effectiveness of the approach is quite high - it allows you to efficiently clean the uterus from foreign inclusions.

But with all this, it is considered quite gentle compared to, for example, curettage. In addition, this method has less possible consequences and complications, in particular, the likelihood of injury is low even when performed blindly.

This procedure is prescribed quite often compared to curettage precisely because of the low trauma. But its significant disadvantage is that tissues extracted in this way cannot be used in the future for research purposes. With curettage, it is possible to create a preparation for study in the laboratory from extracted tissues.

Indications

In what cases is this procedure prescribed and why is it necessary for some diagnoses? In most cases, to this method have to resort to the following diagnoses:

• Hematometra - accumulation of blood in the uterine cavity, which cannot leave it for one reason or another;
• Termination of pregnancy at the request of the woman;
• Additional cleaning to remove gestational products remaining after a medical or surgical abortion (since these processes are quite difficult to clearly control, the membranes of the fertilized egg, etc. may remain in the cavity);
• Cleaning is also carried out as a result of spontaneous abortion (miscarriage), since it also often leaves gestational products in the uterine cavity;
• Sometimes parts of the placenta may remain after full-term delivery, in which case cleaning is also used;
• For frozen pregnancies and pathologies of their course, this procedure is also used;
• For diagnostic purposes, it is used to study the biocenosis of the uterine cavity;
• Severe uterine bleeding and other undesirable conditions;
• For endometriosis, the procedure is indicated to remove the overgrown inner mucous layer of the uterus, as it is rejected under the influence of negative pressure.

In some cases, vacuum cleaning is carried out for other indications, but this happens on an individual basis.

Preparation

Some preparation is required before performing this intervention. If vacuum cleaning of the uterus is carried out after childbirth, then in some cases preparatory activities can be neglected. This is due to the fact that after childbirth the cervix is ​​dilated, and the cavity itself is significantly expanded, as a result of which the intervention is as physiological as possible and causes almost no discomfort. If childbirth has not recently occurred, then full preparation is required, during which the following procedures are carried out:

1. Blood test - general and biochemical to determine common features availability pathological process in organism;
2. Coagulogram is a test for blood clotting, carried out in order to avoid bleeding during the intervention;
3. Analysis for Rh factor and blood group;
4. Testing for HIV, syphilis, hepatitis, as a standard procedure before any manipulation;
5. Vaginal smear for oncocytology, since in this case there may be contraindications to the intervention;
6. A vaginal smear for infections, since if there are infections, you should not carry out the procedure, as there is a risk of infection of the uterus;
7. Examination by a gynecologist for obvious signs of inflammatory and/or infectious process carried out for the same purpose as in the previous case;
8. An electrocardiogram to determine how well the patient will tolerate anesthesia;
9. Examination by a therapist for the same purpose.

Before the procedure, the patient should also notify the doctor about what medications she takes regularly. Your doctor may also recommend stopping certain medications, such as anti-blood clotting medications or hormonal agents, including oral contraceptives.

Progress of the intervention

Vacuum cleaning of the uterus after a miscarriage or abortion, as well as performed for diagnostic purposes, is usually quite painful, and therefore is carried out in a hospital setting under local or regional (epidural) anesthesia. After childbirth, the procedure is often painless and sometimes no anesthesia is administered, depending on how dilated the cervix and the organ cavity itself are.

The procedure itself can be carried out by machine or manually. When using the hardware method, negative pressure in the cavity is created using equipment. The manual method uses a mechanical tube to manually apply negative pressure. The hardware method is almost never used, much more wide use received manual method, the features of which will be discussed below.

1. Dilators are installed on the vagina and cervix;
2. Genital organs are disinfected;
3. Anesthesia is administered;
4. A speculum is inserted into the vagina, with the help of which control will be exercised during the operation;
5. Using a special gynecological probe, the doctor measures the distance from the entrance to the cervical canal to the organ cavity, what you need to know during the subsequent insertion of the tube;
6. An aspiration tube is inserted;
7. Mechanically, the doctor creates negative pressure in it;
8. By rotating it or fixing it at one point, the doctor collects unnecessary material into it.

In some cases, as a result of such intervention, it is even possible to obtain material suitable for further laboratory study and biopsy.

Recovery

This procedure is quite gentle, and in addition, it is considered physiological, because during its course there is no violation of the integrity of the tissues. And the layer of endometrium that peels off during such an intervention should still peel off during the next menstruation. Because recovery period doesn't take too long.

Even without taking additional hormonal medications, the endometrial layer begins to recover on its own from the very first day. And already on the 40-43rd day after the procedure, the first menstruation may begin, after which the normal menstrual cycle will be restored.

After the intervention, it is recommended to avoid sexual intercourse for two weeks. In addition, you need to carefully observe hygiene, do not overheat, avoid swimming and bathing, and use only the shower. You should not use douching and other methods of treatment with vaginal method making.

Consequences

In some cases, when carrying out this procedure, a number of consequences are possible that require immediate elimination:

1. Incomplete abortion during cleansing of gestational products is a condition in which sections of membranes or the like remain in the cavity after the intervention;
2. Damage to the cavity or cervix;
3. Formation of a stable pain syndrome;
4. Air embolism is an extremely rare condition that can be fatal;
5. Inflammatory processes and infection of the uterine cavity;
6. Hormonal imbalance occurs quite rarely, and most likely not due to intervention, but due to the fact of interruption of pregnancy.

In most cases, after such cleaning, a mandatory ultrasound examination of the uterine cavity is prescribed, since the operation is performed blindly, and ultrasound is required to control its quality.

Price

Prices for such interventions can vary significantly depending on the region in which it is carried out, as well as on the status of medical center. Approximate price level for intervention in largest cities is given in the table.

To a large extent, the price of a service depends on the purpose for which it is carried out, since the specifics of its implementation depend on this. This may be a diagnosis, an abortion or a mini-abortion, and for all these conditions the features of the intervention are different.

Conclusion

You should not try to avoid this physiological and fairly simple procedure. Negative complications and the consequences of its implementation are extremely rare. In addition, this is one of the simplest and least traumatic methods of early abortion.

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Vacuum cleaning of the uterus after childbirth is used to remove tissue for examination and treatment of the genital organs. The procedure is carried out special device using local anesthesia or general anesthesia.

Vacuum after childbirth is prescribed in as a last resort when the remains of the placenta have not come out on their own and are possible serious complications against the background of the development of infections and inflammatory processes. The method reduces the likelihood of microtraumas on the cervix and uterine walls.

The main indications for cleaning the uterus with a vacuum after childbirth:

1. conducting a biopsy examination;
2. remnants of parts of the placenta, amniotic sac in the cavity and birth canal;
3. bleeding.

A gynecological examination 2-3 days after birth helps to determine whether the uterus is contracting. If deviations appear, an ultrasound is prescribed, which will show the presence of placental remnants and blood clots inside the cavity of the birth organs.

Vacuum cleaning is also carried out for abortion when detecting fetal malformations, cleansing after miscarriage and frozen pregnancy, and treating infertility. The effectiveness of the method is much higher than manual scraping.

What is a vacuum after childbirth? A procedure to remove blood clots and placenta debris in the uterine cavity without damaging its walls. Aspiration is not dangerous for women's health, performed under local or general anesthesia.

Untimely vacuum aspiration of the uterine cavity after childbirth leads to the development purulent processes, poisoning the body with toxins, refusal breastfeeding. Reproduction in the genitals harmful microorganisms leads to the development of serious postpartum diseases.

Contraindications and features of the procedure

Vacuum aspiration during childbirth is used when a woman’s health deteriorates, her body temperature rises, and uterine bleeding. Such signs indicate inflammation of the genital organs caused by the remnants of the placenta.

During pregnancy, the placenta, in case of pathology, grows to the walls of the uterus. After the baby is born, the placenta is removed by hand, which may leave small parts inside the cavity.

Contraindications for which a uterine vacuum cannot be used after childbirth for clots:

• in the presence of malformations of female organs;
• diseases of the reproductive system;
• infection;
• violation of the integrity of the mucosa;
• neoplasms such as fibroids.

If there are contraindications, the procedure will lead to a deterioration in the health of the mother in labor. In this case use surgical methods treatment.

Features of the vacuum method:

1. Cleaning after childbirth is carried out on 2-3 days. This time is enough for the body to get rid of the placenta on its own. If this does not happen, surgery is performed;
2. the procedure takes no more than half an hour;
3. If blood clotting is poor, a woman may experience severe bleeding. In this case, oxytocin is administered before the manipulation.

Gynecologists prohibit pregnancy within a month after aspiration. It's connected with high probability development of pathologies such as improper formation of the placenta, miscarriage.

Technique of the procedure

Before aspiration, the woman is prescribed diagnostic procedures. This determines the state of health, excludes infectious diseases and pathology of the uterus.

Necessary tests:

• Ultrasound of the genital organs;
• blood and urine tests;
• vaginal smear for oncocytology;
• blood clotting test;

Conduct vacuum cleaning two ways: manual and machine. In the first case, the doctor uses a special syringe that sucks out the remaining tissue from the cavity. At hardware method a medical pump is used.

Is it painful to do vacuum cleaning after childbirth? The aspiration procedure itself is painless, as anesthesia is used. Unpleasant sensations arise at the time of preparation and dilation of the uterus with the help of a dilator.

How does vacuum cleaning of the uterus work after childbirth:

1. genitals are disinfected with iodine and ethyl alcohol;
2. using dilators, the cervix is ​​opened;
3. use local anesthesia. If necessary, apply general anesthesia;
4. a gynecological speculum is inserted into the vagina to help carry out manipulations;
5. A special pump is introduced into the cavity, which creates negative pressure and the clots are cleaned after childbirth with a vacuum into the aspiration tube.

The operation performed allows you to remove parts of the placenta, blood clots, get material for laboratory research. The body recovers quite quickly after the procedure, since the method avoids damage inside the genital organs.

To restore reproductive function, a course of antibiotics is prescribed. The uterine cavity is treated medicinal herbs and decoctions in the absence of allergies. Antispasmodics that affect uterine contraction should be used with caution.

Rehabilitation

After cleaning the uterus, the woman is under the supervision of a doctor to exclude the occurrence of complications. To restore the body, drug treatment is prescribed.

The following methods are used:

• antibacterial drugs intramuscularly and intravenously;
• medicines for uterine contractions;
• hygienic treatment of genitals antiseptics within 7 days.

The woman observes discharge after vacuum aspiration in the first days of the procedure. The heaviest bleeding occurs at 2-3 hours. Within a week, the color and smell of the discharge changes to normal.

If there is bleeding, tampons should not be used; it is recommended to use postpartum pads. It is forbidden to subject the body to physical stress to avoid increased discharge after vacuum cleaning during childbirth. It is not recommended to lift anything heavier than a baby.

During the rehabilitation of the body, nagging pain may occur in the abdominal area. This is due to the fact that the uterus contracts and returns to its original place. After the procedure, you should not take hot baths or visit the sauna.

To maintain lactation, it is necessary to express milk. It is not allowed to breastfeed while taking restorative medications, as active ingredients reach the child through the blood.

You should abstain from sexual relations for a month. Doctors warn against conceiving a child in the first 6-12 months, as miscarriage is possible. It is recommended to plan pregnancy after 6-8 months, when the body and reproductive system have returned to normal.

Complications

Cleaning the uterine cavity is considered complex operation in gynecology and can cause complications. In the first week after manipulation, a woman needs to monitor her well-being.

What symptoms should alert a woman in labor:

• increased body temperature above 39.9 degrees;
• change in the quality of discharge, the appearance of a putrid odor;
• severe bleeding when the postpartum pad is not enough for 2-3 hours;
• complete cessation of discharge within 2-3 days;
• severe nagging pain in the abdominal area;
• dizziness, chills, loss of consciousness.

To exclude inflammatory processes, an ultrasound and vaginal smear are done. A course of antibiotics is required to help the body recover.

Common consequences of vacuum cleaning after childbirth:

1. great blood loss. Often, if the bleeding is not stopped in time, this leads to complete removal of the organ;
2. normalization failure menstrual cycle. Normally, the cycle is restored on days 42-45, when breastfeeding - after the cessation of lactation;
3. infection, the occurrence of inflammatory processes;
4. the appearance of adhesions;
5. fusion of tissues inside the uterus;
6. miscarriage of subsequent pregnancies, rejection of the fertilized egg by the body;
7. greater likelihood of infertility in the future.

Vacuum cleaning causes virtually no damage mechanical damage inside the uterus, but cannot protect a woman from developing possible complications. Early termination of discharge indicates that blood clots remain in the cavity.

Injury to the walls of the cervix leads to isthmic-cervical insufficiency, which causes miscarriages in early pregnancy. Adhesions cause problems conceiving a child.

Abortion and cleansing after pregnancy

To interrupt unwanted pregnancy vacuum is applied no later than 5 weeks. The technique allows you to reduce the risk of infertility during subsequent conception. Abortion is not accompanied by complications or hormonal imbalance.

The shorter the pregnancy, the easier the manipulations are. During the operation, a tube and pump are inserted into the uterus to create back pressure. A gynecological syringe sucks up the contents of the cavity and, together with the fertilized egg, brings it out.

During the operation, a tube is inserted into the cavity, connected to a pump that creates back pressure. This allows the contents of the uterine cavity to be sucked into a special “syringe” along with the fertilized egg.

Vacuum is often used during frozen pregnancy. In this case, abortion is mandatory to avoid the development inflammatory process and decomposition of the fertilized egg in the uterus. Sepsis, or blood poisoning, is fatal.

A miscarriage is the rejection of the fetus by the body for up to 20 weeks. The loss of an embryo may be accompanied by bleeding and abdominal pain. Aspiration is carried out when parts of the fertilized egg remain in the cavity. At heavy bleeding cleaning is done without prior preparation. The procedure is carried out using anesthesia. During rehabilitation, it is possible to take painkillers.

Vacuum cleaning postpartum period effective when parts of the placenta remain in the uterine cavity or blood clots have formed. The procedure helps to avoid the development of infections and inflammatory processes. Rehabilitation takes about two weeks, which allows you to maintain lactation for further feeding of the baby.

If a pathology such as freezing occurs during pregnancy, it is necessary to remove the fetus from the uterus, otherwise serious complications for the woman are inevitable. Cleaning during a frozen pregnancy is the main way to remove a dead fetus. It consists in the fact that a woman under anesthesia has the fetus sucked out with a special rotating tube. There is also medicinal method, but its efficiency is lower.

Causes of fading

A frozen or non-developing pregnancy is a serious pathology in which the death of the embryo occurs without clinical signs miscarriage. It remains in the uterus, in in rare cases- for years. This can happen at any time, but usually up to 13 weeks.

The main reasons are considered:

• hormonal disorders: defects in the functioning of the ovaries and thyroid gland;
• destruction of the fetus immune system(since it is a foreign body for a woman’s body);
• antiphospholipid syndrome;
• infections (herpes, chlamydia, rubella are especially dangerous);
• genetic abnormalities of the embryo;
• external factors: excessive physical activity, stress, bad habits (smoking and drinking alcohol), drug abuse.

There are also situations when pregnancy stops despite the woman’s apparent health and the absence of the above-mentioned reasons. These are called causes of unknown origin.

Women at risk are:

• have had several abortions;
• who had ectopic pregnancy(at least one);
• over 30 years old;
• with an unusual shape of the uterus or suffering from fibroids;
• With endocrine pathologies, most often with diabetes mellitus;
• have had genital infections.

Whatever the reason for the freezing, after the death of the embryo it must be removed as soon as possible, otherwise the woman will develop intoxication or even sepsis (blood poisoning).

Curettage or vacuum cleaning is considered the best method because the doctor can control whether the embryo is completely removed. But they do this after 5 weeks. Before this they prefer medical abortion(the patient is given hormonal drugs causing miscarriage).

However, after it, parts of the embryo may remain inside the uterus, so you still have to do vacuum cleaning or curettage.

Preparing for surgery

Cleaning should be carried out on an empty stomach (do not eat for 8-12 hours, only after this anesthesia is possible), under general anesthesia (in case of intolerance - under local anesthesia, anesthetic is injected into the body and cervix). Before the manipulation, the woman should be examined by a gynecologist to identify possible contraindications, as well as an anesthesiologist to solve the problem of anesthesia.

After this, the question of the process is decided: if there are contraindications, cleaning or scraping should be done with particular caution.

Cleansing may be contraindicated if a woman:

• infectious diseases of the genital organs;
• inflammation of the uterus or appendages;
• the integrity of the mucosa is compromised.

However, the need for surgery does not disappear even in such conditions.

A woman needs to be tested:

• blood test (general);
• Analysis of urine;
• analysis for possible (hidden) infections;
• coagulogram (blood test for clotting);
• bacteriological culture;
• vaginal smear.

After receiving the results, the woman signs consent for the operation.

How is the procedure carried out?

The cleaning process is as follows. Gynecologist:

After extraction, the embryo is sent to histological analysis to find out the cause of the fading.

Curettage is another option for removing a dead embryo from a woman’s uterus.

For this, a curette is used - a special spoon with which the gynecologist scrapes ovum. This procedure is less preferable because it risks damaging the walls or cervix. And general anesthesia is more desirable here - this is a very painful version of the operation.

The manipulation lasts approximately 15 minutes, then you should rest for a couple of hours (first of all, recover from anesthesia). Hospitalization to a hospital is not necessary unless there are more serious pathologies.

Vacuum cleaning is also preferable because it can be done on an outpatient basis. In the future, menstrual function is restored quite quickly.

Postoperative period

After removing the dead fetus, the threat to the woman’s health passes, but complications are still possible:

• Bleeding. Bloody discharge is normal, but if it is too heavy, you should let your doctor know about it, otherwise there may be an accumulation of clots in the uterine cavity or anemia. You should also use only pads - tampons can lead to blood stagnation and inflammation.
• Inflammation (due to damage to the walls during curettage or when the embryo is not completely removed).
• Pain in the lower abdomen, for the elimination of which you need to take painkillers.
• The appearance of adhesions.
• Perforation uterine wall– the most severe complication, requiring surgical intervention.

The first three days the temperature may be elevated (37-37.5°C). This is natural, but if it increases more or lasts more than three days, this is a clear sign of an inflammatory process. This situation should also be reported to your doctor.

In general, after scraping or cleaning, a woman should measure her temperature twice a day for two weeks and monitor her discharge. After these two weeks, she should go to an appointment with a gynecologist and undergo an ultrasound of the pelvic organs to make sure that there is no fetus inside.

The following tests are usually ordered at this time:

• blood test for hormones;
• vaginal smear for microflora and possible infections;
• histological analysis of the uterine epithelium to identify probable pathological condition this organ.

also in postoperative period it is necessary to take vitamin and mineral complexes to strengthen the body, antibiotics to prevent inflammation, as well as hormonal drugs to restore the hormonal system and prevent pregnancy.

Within six months after the termination of a non-developing pregnancy, you cannot plan a new one - it may freeze again, and the woman’s body has not yet recovered. Sexual activity for a month is also unacceptable.

In general, you can resume it when the first menstruation passes normally. In addition, at this time, the woman is treated for diseases that led to the death of the fetus, if any are identified. If depression occurs, a woman is treated by a psychotherapist and takes antidepressants.

In the future, it is imperative to prevent such pathologies:

• be observed by a gynecologist, endocrinologist, sometimes even by a geneticist;
• treat existing sexually transmitted infections, even if they are not severe (chlamydia, trichomoniasis);
• Get vaccinated against rubella and chickenpox at least three months before planning next pregnancy.

If a woman becomes pregnant before the time allowed by doctors, an attempt should be made to maintain this pregnancy.

Firstly, this will comfort the patient who is grieving over the death of her previous child, and secondly, abortion early, even vacuum, increases the risk of miscarriage in the future.

Timely cleaning or even curettage and further attention to your health will allow almost any woman to become pregnant again and give birth to a healthy child.