Miscarriage (Abortion): Surgical Therapy

Surgical therapy – 1st order.

For abortus incipiens – incipient abortion, abortus incompletus – incomplete abortion, abortus completus (complete abortion), or missed abortion (restrained abortion).

• Curettage (scraping of the uterus) – surgical intervention using a blunt curette alternatively as a suction curette (suction curette is the means of choice in the treatment of abortion up to 12 weeks of pregnancy (SSW)).Note: The suction curette can be performed on an outpatient basis under local anesthesia; if necessary Cave! of sedation; if necessary, also antibiotic prophylaxis with doxycycline.

In habitual abortions (women with repeated spontaneous abortions (WSA)).

• Hysteroscopic (by uterine endoscopy).
  • Septal dissection (“septal cutting”) for uterine septum (esp. uterus subseptus) as a prophylaxis against abortion
  • Adhesiolysis for intrauterine adhesions (solutions of adhesions within the uterus).
  • Polyp resection (removal of polyps).

Note: In uterine malformations such as uterus bicornis, uterus didelphys and uterus arcuatus, surgical intervention is not indicated.

Surgical therapy – 2nd orderIn abortus febrilis – febrile or septic abortion.

• Curettage (scraping of the uterus) – only when there is no longer a fever.