Recovery and new pregnancy after curettage of a frozen pregnancy. Cleaning after a frozen pregnancy Repeated cleaning after a frozen pregnancy with anesthesia

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

Unfortunately, in some cases, uterine cleaning is prescribed again. 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 the fertilized egg in the uterine cavity, or the presence of a placental polyp. All this can happen after:

• miscarriage (spontaneous abortion);
• (failed abortion), when the fetus stops developing and dies;
• medical abortion or after one performed in the early stages before 6 weeks of pregnancy;
• unsuccessful abortion in the early stages up to 12 weeks or in the late stages from 13 to 27 weeks strictly for medical reasons;
• artificially induced premature birth, when termination of pregnancy is required beyond 28 weeks and urgent birth.

In addition, there are gynecological indications:

• recurrent bleeding in postmenopause;
• rare, but repeated curettage after removal of the tumor still occurs.

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

• after 3 months when atypia is detected for control;
• if a relapse occurs during hormonal therapy;

How does the re-cleaning procedure work?

The uterine curettage procedure is an operation lasting about 20 minutes under general intravenous anesthesia. The patient falls asleep and does not feel anything. 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 limit themselves to local anesthesia, but pain still remains.

• Before and after surgery, the external genitalia and vagina must be treated.
• Then, using special instruments, 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.

Memo to the patient after repeated cleaning of the uterus

After repeated curettage, it is important to follow the doctor’s recommendations so that no complications arise and you recover faster:

• continue and complete the prescribed treatment (antibacterial, hormonal, hemostatic, uterine contractions and other groups of drugs);
• watch for discharge 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;
• eliminate physical activity;
• You cannot visit the sauna or take a hot bath.

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

• body temperature above 37 degrees, general weakness, dizziness;
• a few days later pain appeared in the lower abdomen and lower back;
• vaginal discharge with an unpleasant odor;
• the volume of bleeding does not decrease or it suddenly stops;
• after 1-1.5 months, discharge does not begin, and the first menstruation may be scanty.

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 uterine mucosa (endometritis);
• perforation of the walls of the uterus during the procedure;
• stenosis (narrowing) of the cervical canal of the cervix;
• 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, a dynamic ultrasound examination and, if necessary, a colposcopy are required.

For better recovery, you can undergo a course of physiotherapy (electrophoresis, mud therapy, acupuncture). Drink more fluids and healthy foods.

Vladlena Razmeritsa, obstetrician-gynecologist, especially for the site

Curettage of the mucous membrane of the cavity and cervix is ​​a rather traumatic procedure. However, in some cases, it is precisely this that allows one to maintain or restore a woman’s health and reproductive abilities. Properly performed medical procedures guarantee the patient a fairly quick restoration of the full functioning of her reproductive organs. Normally, during the postoperative period, a woman’s body temperature should not exceed 37.0 degrees, and spotting appears on the 28-35th day (when removing a frozen fetus - on the 6-7th week). At the same time, the woman is not bothered by pain in the lower abdomen. When subinvolution (insufficient uterine contractions), increased body temperature, severe bleeding and other pathologies occur, specialists most often refer their patients for repeated curettage. This procedure allows you to completely get rid of the remnants of the fertilized egg, inflammatory and other neoplasms. From the remnants of the healthy endometrium, when using correctly selected therapy or taking a course of antibiotics, a new layer of mucous grows.

Gynecological cleansing. Indications

This operation is performed if the following indications exist:

frozen pregnancy (to remove a non-viable fertilized egg and prevent blood poisoning);

In the presence of tumors, polyps, inflammatory processes in the uterine cavity;

After an unprofessional abortion.

How is scraping carried out?

After performing hygienic procedures and injecting the patient with an anesthetic drug, the doctor sequentially inserts special Hegar dilators into the woman’s vagina. They allow you to increase the diameter of the cervix, thereby simplifying further medical procedures. The position of the cervix is ​​fixed using special forceps.

During a frozen pregnancy, specialists first destroy the fertilized egg using a curette for this purpose. Parts of the embryo are then removed using an abortionist or other medical instruments. First you need to scrape the front part of the uterus, then its back wall. Only after this do specialists process the bottom of this genital organ and its tubal angles (in which small parts of the fertilized egg often remain, which can cause inflammation). If the operation is performed during a frozen pregnancy, extreme caution is required from the doctor. As the embryo develops, the uterus becomes very sensitive and can be easily perforated by careless movement of the curette. With excessive efforts, the doctor is able to remove not only the upper, but also the basal layer of the uterine mucosa. Such damage leads to obliteration of the cavity of this organ, the development of secondary amenorrhea, or the appearance of so-called intrauterine synechiae. Immediately after successful emptying of the uterus, its walls contract, which helps stop bleeding.

Is it possible to exclude the possibility of developing pathologies after curettage?

To avoid such dangers, be as careful as possible when choosing the clinic where you will have this operation. The high level of professionalism and vast practical experience of our doctors guarantees each patient a complete restoration of the functioning of her reproductive system. The use of the latest diagnostic and treatment equipment (hysteroscopes, ultrasound, laparoscopic devices) significantly reduces the invasiveness of the surgical operations we perform. And an individual approach to each client and attentive attitude of nursing staff accelerates the restoration of the endometrium of the uterus, the normalization of the psychological state and the increase in the protective forces of the body of each woman.

When does a specialist at our clinic perform repeated curettage?

This operation eliminates the possibility of developing inflammatory processes that reduce a woman’s chances of successfully conceiving a baby (in the future). Repeated uterine curettage is performed when recurrent bleeding occurs during postmenopause. This procedure is also carried out to monitor the condition of the female reproductive system after undergoing a course of hormone therapy, designed to relieve the clinic patient from adenomatosis, adenomatous-type polyps and other diseases affecting women of reproductive age.

A frozen pregnancy is a tragedy and a difficult ordeal. And not only from a physical, but also from a moral point of view. But there is no need to despair. after curettage of a frozen pregnancy is possible. Naturally, you will have to make efforts, but they will be absolutely justified by the successful birth of the baby.

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What is fading

Freezing is a pathological phenomenon in which the fetus in the womb stops developing(dies).

It is wrong to call the curettage procedure an abortion in this situation. Abortion is a term that involves taking away the life of a fetus by removing it from the womb.

In case of freezing, the doctor removes the already dead fetus.

The dead fetus decomposes, toxins penetrate into the blood through the umbilical cord, and after damage to the placenta, the risk of suppuration of the female reproductive organs and abdominal cavity increases significantly.

Rotting spreads through the tissues and the only way out is removal. A complete transfusion can sometimes prevent blood poisoning.

Important! Doctors have no more than 7 days after death to save a woman’s life and her reproductive function.

The timing of the cleansing affects when you can become pregnant after a frozen pregnancy. If the diagnosis was made late, the rehabilitation process is significantly delayed, not to mention cases of resulting infertility.

In the first trimester, toxicosis is confused with symptoms of fading and people seek help late. In case of severe physical condition, it is recommended to do simple blood analysis, which will show fading.

Consequences

In the early stages, curettage is replaced vacuum cleaning. A tube is inserted into the uterus, which, like a vacuum cleaner, sucks the embryo into itself. The method is safe up to 11 weeks of pregnancy.

After 11 weeks, curettage is used - the entire layer of the endometrium, with the attached fetus, is torn off from the wall of the uterus.

After curettage during a frozen pregnancy, a woman will observe a number of characteristic symptoms:

• vaginal bleeding;
• lower abdominal pain;
• pain in the mammary glands;
• temperature increase;
• depression.

Curettage is a wound in the uterine cavity. As long as the top layer does not heal, blood discharge does not cause suspicion. Normally, bleeding is not too heavy, without additional aggravating symptoms, and lasts up to 4 days.

Vaginal discharge can be brown or yellow. Brown spots up to 2 weeks after curettage are considered normal. This could be clotted blood coming out of the healing uterus.

After 14 days, such discharge is not considered normal. Yellow discharge is a sign inflammatory process.

Pain in the lower abdomen is caused by a wound and contraction of the uterus to its natural size.

Contraction is painful because hormonal levels are disrupted and the process does not go as smoothly as after childbirth.

Hormonal changes also affect the condition of the breast. The process of preparing for feeding has already begun, and a sharp reverse motion causes natural pain in the tissues.

Temperature increase normal in the first days, but its growth must be monitored and the appearance of additional symptoms monitored. Inflammation could occur.

The emotional state of a woman who has lost a child is difficult to describe in words and convey. It's terrible.

Complications

Complications after curettage not news. The most common ones are:

• endometritis;
• ovarian cyst;
• depression.

Endometritis – inflammatory process endometrium of the uterus. During the operation, or because the woman does not comply with the rules of the postoperative period, foreign particles enter the uterus and the tissues become inflamed. The disease is accompanied by fever, discharge and pain. The chronic stage of the disease is characterized by infertility, since the egg cannot penetrate into the inflamed endometrium and reliably attach.

An ovarian cyst is a cavity in the ovary filled with fluid. This is a reaction of the hormonal system to a sudden change.

Depression is a very complex disease. It can lead to mental disorders, destroy a marriage, and lead a woman to self-destruction. Impressionable people and ladies who have been waiting for a baby for a long time are especially susceptible to deterioration of their condition. It is very important to undergo training and consult with specialists. The state must not be started under any circumstances! Advanced depression is very common leads to suicide!

Analyzes

Examination after a frozen pregnancy is very important.

Firstly, it allows you to monitor a woman’s health status and prevents possible diseases from developing to a critical stage.

Secondly, establishing the causes of the tragedy will help in the future to successfully become pregnant after a frozen pregnancy and carry the baby to term.

List main research:

• hormone analysis;
• STD testing;
• immunogram;
• histological examination;
• microflora smear.

An ultrasound is performed on the 10th day after cleaning to confirm that there are no particles of fertilized egg left in the uterus. If there are particles, repeat cleaning is prescribed, otherwise it will start inflammation and suppuration.

Hormone analysis is necessary for 2 reasons: to determine the current condition, and to prescribe a course of hormones to maintain the body, because not every woman’s hormonal levels balance out on their own. In the future, the hormonal background will show whether a deviation in his work was the cause of the freezing. The second analysis is done later, when the body is restored and the woman begins to think about conceiving again.

STDs are sexually transmitted diseases. They cause pathologies in both the mother and the fetus, which leads to freezing.

An immunogram is an analysis of the functioning of the immune system. Failures in its operation lead to freezing. The analysis is carried out in the late period of rehabilitation.

If a woman is not recovering well, an immunogram may be needed to determine her current condition and prescribe the correct treatment.

Histological examination – fetal examination for the presence of developmental pathologies. The result will help you bear a child in the future.

A microflora smear determines the woman’s current condition and makes it possible to identify a number of diseases that provoke fading. This knowledge is necessary for successful treatment and preparation for a new conception.

Treatment

Treatment after a frozen pregnancy involves 3 points:

• scraping;
• taking antibiotics;
• hormonal therapy.

Antibiotics are always prescribed - they do not allow inflammation. As a rule, broad-spectrum antibiotics are prescribed. Taking hormones is not always prescribed, but in cases where the female body cannot cope on its own. You cannot choose medications on your own - it is easy to develop complications, because the female body is greatly weakened.

Recovery

Recovery after curettage of a frozen pregnancy long process, taking place in 3 stages:

• bring the body back to normal after the procedure;
• undergo a course of treatment to eliminate the problem that caused freezing;
• accumulate strength to conceive again.

Recovery of the endometrium after curettage may take longer for 2 months.

It depends on individual characteristics, hormonal background, immune system and the presence/absence of complications.

One of the signs of successful recovery is menstruation. They show that the hormones are working “as intended” and their quantity is sufficient.

The very fact of menstruation shows that the endometrium has grown and moved away naturally. Full recovery may take up to 2 menstrual cycles.

After scraping delay of menstruation Normally it is up to 45 days if it is not accompanied by additional symptoms:

• pain;
• strange discharge;
• unpleasant odor;
• heat.

Additional symptoms or delay of more than 45 days signals deviations in hormonal background, inflammatory processes or remnants of the fertilized egg.

New pregnancy

Pregnancy after a frozen pregnancy must be approached with all responsibility! Necessary:

• fully recover after the procedure;
• find out the reason the occurrence of pathology;
• undergo a course of treatment;
• prepare the body for a new conception.

The first question that arises in a woman after curettage is whether it is possible to get pregnant after a frozen one? The answer is yes, but there are conditions:

• curettage must be carried out on time so that suppuration does not have time to affect the uterus and all reproductive organs remain healthy;
• establish and eliminate the cause of the fading;
• hormonal levels must correspond to standards;
• endure the rehabilitation course and not become pregnant until its completion;
• undergo a course of recovery from psychological trauma, if necessary. Morale is very important and can cause miscarriage or death.

An important point - when can you get pregnant after a frozen pregnancy? Recommended period: wait from one to two years, depending on individual characteristics.

During this period, the body will probably recover, you will be able to get rid of all bad habits, your diet will improve, and your hormonal levels will return to normal.

The second important aspect is how long before you can prepare for re-fertilization? After half a year - not earlier.

In 6 months, most pathologies leading to freezing are cured, or most of the course of their treatment is completed. The overlap of courses of therapeutic and preparatory therapy can lead to undesirable consequences.

Preparing for pregnancy after frozen suggests:

• quit bad habits;
• get out of depression;
• take vitamins;
• lead a healthy lifestyle;
• watch your diet.

General advice includes temporary (until the gynecologist's permission) prohibitions on:

• sexual contact;
• use of sanitary tampons;
• douching;
• taking baths and visiting the pool;
• hypothermia;
• heavy physical activity and heavy lifting;
• pregnancy in the first six months after cleaning.

Penetration of any foreign object, including water, into the vagina and hypothermia are fraught with inflammation. Physical activity tones the uterus - this means pain and possible bleeding. It will not be possible to carry out an early pregnancy, and the body will “remember” the reaction even better.

Pregnancy after curettage of a frozen pregnancy is feasible and occurs in 9 out of 10 cases. It is very important to allow your body to fully restore its strength, and not to rush things. you can find out by following the link.

Useful video: is a new pregnancy possible after curettage of a frozen one?

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Sometimes it happens that the fetus, instead of growing and developing normally in the mother’s womb, dies. The pregnancy is fading. It is already impossible to save the child, but this condition is dangerous for the woman, and in order to prevent negative consequences, cleaning is carried out after a frozen pregnancy. After this procedure, it takes a certain amount of time to restore the woman’s health – usually at least 3 months.

What is cleaning and how does it work?

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

Medicinal 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

Using a special instrument, the cervix is ​​opened slightly, an extractor is inserted into the organ and its contents are sucked out. The operation is performed under local or general anesthesia. The uterine epithelium is minimally damaged during the procedure, and bleeding after such an intervention does not last long (1-3 days). Vacuum aspiration is done for 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 tests in preparation for the operation). The uterine endometrium is cleaned using special instruments.

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 birth

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

After removal from the uterus, the dead embryo is sent for a histological examination to identify the causes of developmental arrest.

After 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 setting and in compliance with all the rules of asepsis and antisepsis, after removing a frozen embryo from a woman, the following complications may arise:

• Endometritis (acute inflammatory process of damaged uterine mucosa).
• Rupture of the uterine cervix. Such tears take a long time to heal on their own and can fester. To prevent secondary infection, immediate suturing of such traumatic cracks in the neck is necessary.
• Incomplete removal of pieces of the fertilized egg, which begin to be rejected by the woman’s immune system, causing hyperthermia and severe pain. In severe cases, if you do not seek medical help in a timely manner, sepsis may develop.

In order to notice signs of developing complications in time, such moments must be carefully monitored in the first days after surgical treatment.

Body temperature

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

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

Discharge

Normally, the discharge will be scanty and bloody, reminiscent of menstrual “smudge.” The presence of strong bloody discharge or discharge with an unpleasant odor and with additional impurities in the blood will indicate the presence of a pathological process.

Pain syndrome

In the first 2 days after embryo extraction, due to instrumental intervention, mild pain in the lower abdomen is possible.

But prolonged or intense pain 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.

Restoration of the body

To recover from a frozen pregnancy and the subsequent removal 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, and hCG (pregnancy hormone) will be removed from the body. Despite the fact that 3 months is enough for recovery, doctors recommend planning a pregnancy after curettage of a frozen 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 embryo death in subsequent pregnancies, the following treatment is prescribed after cleansing.

Antibacterial therapy

As a preventive measure for secondary infection after curettage, especially if fetal freezing was not immediately detected, broad-spectrum antibiotics are prescribed.

If the patient has purulent discharge or discharge with an unpleasant odor, medications are selected individually for her, 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 agents

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

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 carry and give birth to a healthy child, you must:

• Plan a pregnancy no 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 was unable to provide the embryo with the substances necessary for development.
• Prepare yourself psychologically and believe that this time everything will go well, and enjoy the feeling of upcoming motherhood. You should not plan to conceive if you are still afraid of losing your child.

A frozen pregnancy is not a death sentence, and the risk of a recurrence is minimal. You only need to pay careful attention to your health and psychological state during the recovery period after cleansing, and then you will have a good chance of giving birth to a healthy child.

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

Often for such a procedure it is necessary for the uterus to open; it is opened using special instruments. Curettage is usually done to diagnose the treatment of a particular gynecological disease or for other purposes.

When is this procedure necessary?

This will have to be done if pathologies are detected on the uterus

Curettage is done in cases where:

• changes in the endometrium that are detected on ultrasound. When the doctor detects any formations or thickening of the endometrium. In order to establish an accurate diagnosis of the disease;
• menstrual irregularities. When there is heavy discharge, menstruation does not stop for a long time. When pregnancy does not occur, no pathologies have been identified. Bleeding during menopause. Bleeding occurs between periods;
• Pathologies were detected on the uterus. During the examination, the doctor revealed abnormalities associated with the cervix, suspicions of malignant diseases;
• miscarriage. Prescribed by a gynecologist in order to remove the remains that remain in the uterus, particles of the placenta. Also, the remains of the fertilized egg are removed after childbirth;
• frozen pregnancy. Not every woman's pregnancy always goes well. There are cases of frozen pregnancy, and curettage is necessary;
• problems with conception, infertility.

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

Preparation for surgery

When an ultrasound specialist determines that the fetus has no signs of life, the woman will have to undergo a curettage or cleaning procedure, which is done in the case of a frozen 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 such a procedure.

Training takes place exclusively under the supervision of specialists

In order for the operation (after all, it is a surgical intervention) to be successful, a specialist will prescribe the necessary examinations to ensure your safety. You need to take a blood test, a coagulogram (a test that is performed to determine blood clotting), and a bacteriological smear.

Many people are interested in how to do curettage during a frozen pregnancy? The embryo and its membranes will be removed. You will be required to provide written consent for the operation. On the eve of the operation, you will need to stop eating and drinking for eight to twelve hours. This is all done in order to safely administer anesthesia. It is necessary to inform your doctor about taking medications (in connection with the disease), if you are taking them.

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

The operation is usually performed under general anesthesia, administered intravenously, and its effect lasts from fifteen to twenty-five minutes. After administering the drug, you fall asleep within a few seconds. You will wake up in the ward, but you will not receive any sensations from the operation.

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

Usually the woman will sleep for several hours with ice on her stomach. Afterwards, you can go home if you wish, or you can be observed at the clinic for a while. As a result, the entire procedure lasts about twenty minutes.

The doctor prescribes certain medications to reduce pain. Antibiotics are often prescribed to prevent infection. Physical therapy may be prescribed. An appointment is made and further actions are discussed with the doctor in order to avoid unpleasant consequences from curettage during a frozen pregnancy.

: Borovikova Olga

gynecologist, ultrasound doctor, geneticist