Abortion curettage (synonyms: abortion curettage; curettage; curettage) is the scraping of the uterus in which a disturbed pregnancy has remained. Up to the 12th week of pregnancy, one speaks of an early abortion from the 13th to the 24th week of pregnancy of a late abortion.
Indications (areas of application)
- Missed abortion (restrained miscarriage; in this case, the amniotic sac has died but is not expelled from the uterus)
- Abortion (miscarriage)
The surgical procedure
Before the procedure, the urinary bladder is generally emptied by means of a catheter. If it is determined by the 13th week of pregnancy that the pregnancy is disturbed or dead, the cervix is dilated (widened) and then the uterine cavity is emptied, as in the case of abrasio (scraping). The procedure is independent of whether the cervix is still completely closed, as in a restrained abortion, or whether there is already some bleeding, as in an incipient abortion. In contrast to the scraping out of a non-pregnant uterus, the emptying of the uterus is done either with a blunt curette so as not to injure the uterus, which has been loosened by the pregnancy, or alternatively with a so-called suction curette, in which a tube is inserted into the uterus and the pregnancy is sucked out by negative pressure. Both methods are also frequently used. Usually, the suction curette is used first, followed by the blunt curette. If the cervix is still completely closed, additional pre-treatment with medication may be useful. For this purpose, prostaglandin (a drug used to induce labor) is introduced into the vagina or cervix, which leads to softening and partial opening of the cervix. This facilitates dilatation and largely reduces late effects such as cervical insufficiency (weakness of the cervix) in later pregnancies. In a late abortion, the pregnancy has practically always been only partially expelled. Further emptying of the uterine cavity is therefore referred to as post-curettage. Depending on how far the cervix has been opened, further dilatation of the cervix may be required to completely empty the uterine cavity, depending on the amount of remaining residue and the age of the pregnancy. In this procedure, too, one uses either a blunt curette or a suction curette. Often both instruments are used in one session.
The procedure, which takes about 10-15 minutes, is usually performed under anesthesia.
Possible complications
- Injury or perforation (piercing) of the uterine wall with the instruments, possibly with damage to adjacent organs (bowel, urinary bladder) is rare.
- Light bleeding after hours or days is normal.
- Residual tissue left behind may occur. This then usually leads to prolonged bleeding and thereby to a discharge of the tissue remnants.
- Infections or wound healing disorders (very rare).
- Adhesions of the cervix, cervical canal, uterine cavity as a result of infection is possible. This can lead to menstrual disorders (cycle disorders) and / or conception difficulties (difficulties conceiving), possibly to sterility (infertility) (very rare).
- Hypersensitivity or allergies (e.g., anesthetics/anesthetics, medications, etc.) may temporarily cause the following symptoms: Swelling, rash, itching, sneezing, watery eyes, dizziness or vomiting.
