Uterus after abortion: recovery period and possible complications

In the article we will look at drugs for contracting the uterus after childbirth, abortion and miscarriage.

During the postpartum period, the female body goes through a mandatory recovery stage. It is necessary to normalize hormonal balance, as well as to return internal organs to their original position. The uterus in which the baby developed can shrink up to 500 times after birth. When this process occurs too slowly or stops completely, the woman is prescribed special drugs to contract the uterus.

Reasons for appointment

The uterus is the main organ of the female reproductive system, which has the ability to stretch significantly and then quickly shrink after childbirth. Sometimes the organ may require medicinal support.

Drugs for uterine contraction are prescribed in the following situations:

Inactive labor.
After an artificial termination of pregnancy. Drugs for uterine contraction after abortion will be described in detail below.
For the purpose of removing lochia.
Bleeding in the reproductive organs.
Amenorrhea.
Neoplasms in the uterus.

Medicines are also prescribed to contract the uterus after a miscarriage.

If at the initial stage of the birth process there is no activity of the uterus, drip administration of drugs designed to enhance the contractility of the organ is prescribed. This is necessary to ensure that the child does not develop hypoxia due to too slow labor. The justification for the use of special drugs may be insufficient dilatation of the uterine cervix, as well as the position of the fetus with its head inserted into the pelvis.

After an abortion, it is also important to allow the uterus to recover. For this purpose, drugs are prescribed to contract the uterus, toning the organ. This helps the body eliminate blood clots after surgery.

Sometimes a woman may have a miscarriage, or she is forced to have an abortion according to indications. In this case, it will also not be possible to do without medications. Drugs to contract the uterus for miscarriage are administered over several days. This promotes rapid cleansing of the uterine cavity and facilitates the rehabilitation process.

To correctly prescribe, the doctor must understand the types of drugs for uterine contraction after childbirth and miscarriage. There are drugs that increase the number of uterine contractions, as well as those that affect the tone of the myometrium.

Do's and don'ts after an abortion: rehabilitation, discharge, sex life, pain, cycle restoration

Many women have undergone or are about to undergo an abortion; they are partially familiar with the potential complications and consequences, but do not fully understand the entire rehabilitation process and its necessity and duration.

Why is it necessary to exclude certain aspects from your usual lifestyle after an abortion? Certain prohibitions are included in the rehabilitation complex and help restore not only physical health, but also prevent possible infertility in the future (see consequences and complications of abortion).

Termination of pregnancy is a severe stress for the body, therefore, after an abortion, the regulation of the functions of the ovarian-menstrual cycle is disrupted. Due to the significantly increased load on all organs during gestation, the hypothalamus is in a state of excitement, which affects the work of the pituitary gland, which ceases to synthesize gonadotropins (FSH and LH) in the required proportions.

And instead of the periodic release of luteinizing hormone, characteristic of the normal menstrual cycle, its monotonous increased secretion is noted, as a result of which the ovaries enlarge and begin to synthesize estrogens. But with the physiological completion of pregnancy, all changes that occur disappear without consequences for health. With forced termination of pregnancy, the anatomical stage of menstrual dysfunction develops, which leads to the development of the following pathological conditions:

insufficiency of the luteal (phase 2) cycle;
secondary polycystic ovary syndrome;
hyperplastic processes of the endometrium;
uterine fibroids;
syndrome or Itsenko-Cushing's disease.

The listed pathology is caused by excess production of LH after its previous monotonous secretion, so the restoration of ovarian-menstrual function sometimes takes more than one month, in some cases several years.

How many days after an abortion will menstruation begin is difficult to answer, it depends on a number of factors:

woman's age;
existing chronic diseases;
method of abortion;
gestational age when the abortion was performed;
during the postoperative period.

Normally, a healthy and young woman should begin her period after an abortion in about a month, or rather, after the period of time that lasted from the previous menstruation to the current one. To calculate the approximate date of the first menstruation after the procedure, the starting point (the first day of the cycle) should be the day of the abortion.

However, artificial termination of pregnancy can not only lengthen or shorten the duration of the menstrual cycle, but also change the nature of the discharge. It is possible that scanty, spotting discharge may appear after an abortion, which continues for one to two menstrual cycles and is associated with incomplete restoration of the endometrium after the procedure.

If scanty menstruation persists for a longer time, this is a reason to consult a doctor, as well as for an extensive examination. A decrease in menstrual blood loss may be due to two reasons.

The first is a functional failure in the production of hormones by the ovaries, pituitary gland and hypothalamus. Often, a similar condition is observed after a medical abortion, which is associated with taking very large doses of antiprogestins and requires the appointment of appropriate hormonal therapy.
The second reason is mechanical damage to the endometrium (overly “thorough” scraping of the mucosa and traumatization of its deep layers) and/or the cervix (cervical canal atresia). When the endometrium is injured, synechiae (adhesions in the pelvis) are formed in the uterine cavity, which reduce not only its volume, but also the area of the endometrium, which is rejected during menstruation.

In addition to opsomenorrhea (scanty menstruation), amenorrhea and infertility may occur. Intrauterine synechiae requires hysteroscopic dissection.

If your periods after termination of pregnancy become heavier and repeat for several cycles, you should also be wary. Heavy and prolonged menstruation may indicate:

or about the development of endometrial hyperplasia
or about adenomyosis (endometriosis of the uterus).

And although menstrual flow after an abortion can be restored immediately, that is, it begins after 21–35 days, ovulation may be absent for two to three menstrual cycles, which is considered normal. If anovulation lasts longer, but there are no visible cycle disorders, you need to start looking for the cause of this pathology.

Immediately after an uneventful abortion, the discharge should normally be moderate, with a small number of clots. However, both the volume and duration of bleeding depend both on the duration of the terminated pregnancy and on the method of termination.

Small and even scanty discharge is observed after a vacuum abortion. This is explained by the short duration of pregnancy, and, accordingly, minor trauma to the uterine mucosa.
After a surgical abortion, especially at 10–12 weeks, the discharge will be more intense and prolonged.

How many days after an abortion does bleeding continue? The duration of bleeding after a well-performed procedure is normally 7, maximum 10 days. If the discharge continues for more than 10 days, the first thing to exclude is the placental polyp, which is removed by repeated curettage of the uterine cavity. That’s why it’s so important to see a gynecologist after 10–14 days, who will not only palpate the uterus and suspect subinvolution or placental polyp, but also prescribe a pelvic ultrasound.

If clots and heavy bleeding occur after an abortion, regardless of when it was performed, a day or 2 weeks ago, you should immediately seek qualified medical help, since the presence of remnants of the fertilized egg or hematometer in the uterine cavity cannot be ruled out.

After an uncomplicated termination of pregnancy, moderate pain in the lower abdomen or slight discomfort is normally possible. Such sensations can last up to 7 days and do not particularly bother the patient. If your stomach hurts so badly that it is impossible to lead your usual lifestyle and leads to loss of ability to work, this is a reason to immediately contact a specialist.

Cramping and sharp pain indicate the remains of placental tissue and embryo in the uterine cavity and the development of hematometra
Aching, constant pain combined with an elevated temperature after an abortion are a sign of the onset of inflammation, which can be triggered by sexually transmitted infections that remain asymptomatic for some time.
In general, in the first 2 days after the procedure, a slight increase in temperature (37.2 - 37.3) is not a pathology, but only reflects the body’s reaction to surgery. Low-grade fever is also possible on the day of a medical abortion as a reaction of the thermoregulation center located in the brain to taking high doses of hormones.
But if a high temperature (more than 37.5) persists for more than 2 days, this is a sign of trouble and a reason to seek medical attention. help.

To prevent the development of inflammatory diseases after medical termination of pregnancy, patients, especially those with unsatisfactory results of smears and blood/urine tests, are prescribed a prophylactic course of broad-spectrum antibacterial and anti-inflammatory drugs for 3 to 5 days (maximum 7 days). In the case of a confirmed inflammatory process, the dose of antibiotics is increased and the course lengthened.

Also, to prevent septic post-abortion complications, the doctor will definitely recommend staying away from drafts and colds, dressing warmly in damp and cold weather, and taking a shower daily. Equally important is following the rules of personal hygiene:

treating the external genitalia with water at least 2 times a day;
timely change of pads and underwear, since the blood spilled from the uterine cavity and retained on intimate hygiene products is a good breeding ground for microorganisms, which contributes to their active reproduction and penetration into the uterus, where they cause inflammation.

Every woman who has artificially terminated a pregnancy should know that drinking alcohol in the post-abortion period is strictly prohibited, especially if she is taking antibacterial drugs.

Firstly, under the influence of alcohol, antibiotics are destroyed, which means that taking them will be absolutely useless and will not reduce the risk of developing post-abortion septic complications.
Secondly, alcohol reduces the tone of smooth muscles (the myometrium consists of smooth muscles), which prevents its contraction and involution (return to its previous size) after removal of pregnancy and can cause bleeding.

The most damaged organ after an abortion is the uterus. The longer the abortion was performed, the more significant its damage. This is especially true for instrumental curettage of the embryo.

The uterus after an abortion begins to contract immediately after the embryo is removed and returns to its normal or almost normal size by the end of the procedure. However, a wound surface is formed on the uterine wall (in the place where the fertilized egg was attached), which requires a certain time period for its healing and restoration of the endometrium, ready for transformation and rejection during menstruation.

Normally, this takes 3–4 weeks, and by the beginning of a new menstruation (after a previous abortion), the uterus has its normal size and transformed epithelium.
But if, upon examination 10 to 12 days later, which is mandatory after the procedure, an enlarged, softened and painful uterus is palpated, and the discharge is dark red or the color of “meat slop”, with an unpleasant odor, scanty or moderate, then we are talking about inflammation of the organ.

The causes of endometritis can be a poorly performed abortion (remnants of the fertilized egg), activation of a latent infection or infection during the abortion (violation of aseptic standards) or after (non-compliance with recommendations), or the formation of hematometra. Therefore, all women after an abortion are prescribed not only a follow-up visit to the gynecologist, but also a mandatory ultrasound, during which it is confirmed that the uterus is “clean”.

Based on the above, it becomes clear that sex after an abortion must be excluded. The gynecologist will definitely warn a woman who has undergone an abortion procedure that she should observe sexual rest for at least 3 weeks (after a mini-abortion and pharmacological abortion).

Over the specified period of time, the uterus should return to normal. But in the case of instrumental or classic abortion, especially in long periods, the prohibition of sexual activity is extended to 4 weeks, optimally until the end of menstruation.

Firstly, this is due to the high risk of infection of the uterus and the development of inflammation
Secondly, sexual intercourse can disrupt the contractile activity of the uterus, which will provoke its subinvolution or hematometra, and again lead to inflammation.
In addition, having sex can cause pain after an abortion.

Not many former clients of the abortion clinic know that after an abortion you can get pregnant, and very quickly, even before the onset of your first menstruation. In this case, a parallel can be drawn with pregnancy, which occurs immediately after the birth of a child if a woman refuses lactation.

After the sudden termination of pregnancy, the body begins to actively rebuild and returns to its usual rhythm. That is, the ovaries are preparing for a new menstruation; under the influence of pituitary gonadotropins (FSH and LH), they gradually produce estrogens and then progesterone, which stimulates the maturation of follicles and ovulation.

Therefore, in more than half of the cases, a woman’s first ovulation occurs within 14–21 days. And if we take into account the lifespan of sperm (up to 7 days), then pregnancy after an abortion is very likely.

On the other hand, if a woman, after a recent termination of pregnancy due to circumstances, wants to give birth to a child, then it is necessary to abstain from pregnancy for a certain time.

It is believed that the minimum period of birth control after a previous abortion is 6 months. It is optimal if the desired pregnancy occurs within a year, and after a thorough examination and treatment of identified diseases.

It is during this period of time that the body will fully recover, and the risk of pregnancy complications associated with its previous violent termination will noticeably decrease (isthmic-cervical insufficiency, hormonal imbalance, improper attachment of the fertilized egg, intrauterine growth retardation).

Also, speaking about pregnancy that occurred immediately after an abortion, we should also talk about tests to determine it. After an abortion, the test will be positive, and this result will remain for another 4 to 6 weeks (if the termination of the pregnancy was long, the positive result will remain longer).

HCG is not immediately destroyed and excreted from the woman’s body, this process is quite slow, therefore a positive result cannot be considered a sign of pregnancy (the case of either the ovum not being removed during an abortion, or the onset of a new one). The only thing that can cast doubt on the “positivity” of the test is that the second line in each new test will be lighter (see pregnancy test).

To accurately establish the fact of pregnancy, an ultrasound is performed, and in some situations, a blood test for hCG several times in a row; in the case of a progressive decrease in the level of hCG in the tests, a false positive test result is indicated.

Immediately after an abortion, or better yet before the procedure, it is necessary to select a method of contraception. The optimal solution in this case is to take hormonal contraceptive pills, as they mitigate the effects of hormonal stress, prevent neuroendocrine disorders, and, in addition, significantly reduce the risk of developing septic complications after abortion, which is explained by the following mechanisms:

reducing the amount of blood lost during menstruation (blood acts as a breeding ground for microbes);
thickening of the cervical mucus, which not only prevents the penetration of “live creatures” into the uterine cavity, but also pathogens;
the cervical canal does not expand so significantly during menstruation (protection against infection);
the intensity of uterine contractions is reduced, thereby reducing the risk of the spread of pathogens of infectious diseases from the uterus to the tubes.

It is recommended to take low-dose oral contraceptives, the dose of ethinyl estradiol in which does not exceed 35 mcg, since estrogens increase blood clotting, and hypercoagulation is noted during the first 20 to 30 days after termination of pregnancy. Such drugs include Regulon, Rigevidon, Mercilon.

Taking the pills should start on the day of the abortion and continue according to the schedule. The day of termination of pregnancy will be counted as the first day of a new cycle.

During the post-abortion period (about a month), taking a bath is not recommended, as this may cause bleeding or the development of endometritis.

Is it permissible to use sanitary tampons after an abortion?

For intimate hygiene products after an abortion, preference should be given to pads, and the use of tampons is strictly prohibited, since bloody discharge absorbed by the tampon remains in the vagina with it and is an excellent environment for the proliferation of microorganisms, which increases the risk of developing post-abortion inflammation.

How long after an abortion can I go to the swimming pool?

Visiting the pool, as well as bathhouses and saunas (air temperature is too high), swimming in open water should be postponed for at least a month, until the end of the first menstruation. Otherwise, you can “catch” an infection or increase bleeding, even bleeding.

If the termination procedure “passed” without complications and the woman’s condition is satisfactory, then you can return to sports within a couple of weeks after the termination of pregnancy. But the load should not be so intense during the month after the abortion.

Why does the breast hurt and bother you after an abortion (the abortion was performed 3 days ago)?

Perhaps the term of the terminated pregnancy was long enough, and the mammary glands began to actively prepare for the upcoming lactation. But a suddenly terminated pregnancy led to a hormonal imbalance; the body and mammary glands, among other things, did not have time to rebuild, which led to chest pain.

No, you do not need to follow a special diet during the post-abortion period. But if the abortion took place under general anesthesia and the anesthesiologist diagnosed an allergic reaction to the anesthetic, he may advise further adherence to a hypoallergenic diet (limiting chocolate, citrus fruits, coffee, seafood and other allergenic foods).

A week passed after the abortion, I wanted to go to the seaside, is it dangerous?

The trip to the sea will have to be postponed. Firstly, a sharp change in climatic conditions is unfavorable for the restoration of the body, and, secondly, swimming in the post-abortion period is prohibited.

Based on materials from zdravotvet.ru

Drugs to enhance uterine contractions

Drugs for uterine contraction have a fairly wide range of applications. On the one hand, they are designed to preserve gestation and also help improve blood flow to the placenta. Also, these drugs are prescribed to relax the muscles of the uterus during spasms. On the other hand, medications are used to stimulate the process of delivery in order to increase uterine tone.

Many people are interested in what drugs cause uterine contractions.

The most common drugs in this group are the following medications.

The active substance of the same name is a human hormone that affects the number of uterine contractions and also increases tone before childbirth. When oxytocin is produced in insufficient quantities, a woman experiences weak labor. To enhance uterine contractions, oxytocin is administered intravenously or intramuscularly, and during a cesarean section - directly into the uterus. Indications for its use are incomplete miscarriage, weak labor activity, and a gestational age of more than 42 weeks. Contraindications for the use of the solution are polyhydramnios, abnormal position of the fetus, the presence of scars on the uterus, and premature birth. When using oxytocin, undesirable reactions such as bronchospasm, high blood pressure, nausea and vomiting, and increased heart rate may occur. It is important to constantly monitor the patient’s blood pressure and pulse while using the drug.

The drug is prescribed to stimulate uterine contractions after an abortion or cesarean section as a restorative therapy. The drug can be taken during lactation; the standard dosage is two tablets three times a day. The drug must be taken in a hospital setting under medical supervision. This remedy is contraindicated for liver or kidney pathologies, asthma, hematological diseases, allergies and weakness of auditory perception.

The basis of the drug is oxytocin, the properties of which contribute to compression of the uterus during full-term or post-term pregnancy, as well as stopping bleeding after childbirth. If labor is insufficiently active, the doctor prescribes a tablet form of the drug. While pushing, an injection of the drug is given. Contraindications for use are narrow pelvic bones, large size of the fetus, as well as a caesarean section during the first birth.

These drugs are also used to contract the uterus after cesarean section.

Blood loss after abortion with pills

It is possible to minimize the risk of various types of complications and avoid heavy bleeding. To do this, you need to contact a professional specialist. He will be able to perform an abortion correctly and will also be with the patient throughout the entire rehabilitation period. The doctor will monitor the patient’s health condition and prescribe appropriate treatment.

As a rule, clinics that have gynecology departments are equipped with modern equipment and medications. They do not pose a danger to their patients; as a result, the abortion will take place correctly and without complications. After all, bleeding after medical termination of pregnancy can be a very serious problem, which, if left unchecked, can only harm your health. Professional doctors with many years of experience in the field of gynecology get down to business. Therefore, the patient will quickly and without complications regain her strength and will have an excellent opportunity to become a mother next time. It is of great importance to take tests before terminating a pregnancy, for example, the norm of hemoglobin, as well as platelets and leukocytes during pregnancy . Using these data, negative abortion outcomes can be avoided.

It should be noted that if you have chosen a pharmacological abortion, then this method is more welcomed by doctors, as it is considered safe. This procedure has absolutely no complications. However, the only complication may be bleeding. It is this that can cause the patient a lot of trouble, even life-threatening. Therefore, doctors strongly recommend not to have an abortion if this is your first pregnancy.

The very appearance of bleeding can be explained as follows: a drug called mifepristone is used for abortion, which can cause uterine contractions. If the dose of this drug is 600 mg, then blood may automatically stop flowing into the fertilized egg. Which will subsequently contribute to uterine contractions. After this, bleeding occurs after several hours after the abortion was performed. If the patient’s uterus contracts normally, then this can help the woman, and she will return to her previous state, which does not threaten her health. But if the uterus has not contracted enough, then after a couple of days the specialist prescribes the patient to take medications. They will stimulate the contractile system of the uterus.

Typically, after a medical abortion has been performed, blood loss is approximately 9-11 days. Many women experience bleeding until their next menstrual cycle.

Based on materials from hematologiya.ru

Preparations for myometrial stimulation

Medicines from this group are intended to stimulate myometrial contractions to terminate an unwanted pregnancy or increase tone during the period after childbirth. Sometimes these medications are prescribed to prepare the uterine cervix. The following drugs are distinguished:

In some cases, women prefer homeopathic medicines, rightly considering them safer and milder in their effects.

We looked at medications for uterine contractions after childbirth, miscarriage and abortion.

Traditional methods of uterine contraction

During the postpartum period, a woman's body needs some time to recover. Lactation is the first aid for a woman in this process. During breastfeeding, the body begins to produce oxytocin. Special exercises aimed at strengthening uterine contractions are also considered effective.

Quite often, women use herbal decoctions and various tinctures. For example, barberry has a hemostatic effect. Nettle extract in liquid form also helps increase the intensity of uterine contractions after childbirth. You can prepare the product yourself or purchase it at a pharmacy. No less effective is the guillemot in the form of an extract. This plant also helps normalize lactation.

Taking any medications, including infusions and herbs, requires mandatory consultation with a specialist.

We looked at what drugs are prescribed to contract the uterus.

Contraction of the uterus after an abortion at different stages of pregnancy can occur in different ways, and the greatest number of complications occur when the late stages of gestation are interrupted. Drugs for normalizing the contractile activity of the uterus are aimed at speedy involution of the myometrium when it is hypotonous. The danger of slowing down uterine contractions is bleeding from the spiral uterine arteries that fed the chorion and placenta.

Medical tactics when prescribing drugs for uterine contraction are determined by the type of termination of pregnancy, the duration and the presence of concomitant pathology in the woman. The rate of uterine contraction after a miscarriage or abortion is determined by the reasons for the interruption and the method of manipulation:

spontaneous miscarriage up to 12 weeks;
spontaneous miscarriage after 13 weeks;
vacuum aspiration up to 20 days delay;
vacuum abortion up to 8 weeks;
curettage up to 12 weeks;
cleaning after a miscarriage in late pregnancy (16 – 27 weeks);
fruit-destroying operations and late-stage cleaning.

After vacuum aspiration or miscarriage for up to 8 weeks, the uterus contracts quickly and almost never requires the use of drugs.

If a woman decides to terminate her pregnancy, doctors recommend contacting specialists as early as possible to perform minimally invasive interventions. In modern obstetrics, methods of medical abortion are used, which are used until the 25th day of missed menstruation, which corresponds to 3–4 weeks. With this development of events, the woman’s hormonal background is subject to enormous interference, but the consequences of such an abortion are minimal for subsequent pregnancies.

For gestational age up to 8 weeks, doctors use a vacuum abortion method, in which the contents of the uterine cavity are removed by creating negative pressure. If the gynecologist has extensive experience, then after an abortion the uterus contracts quickly and no medications or additional cleaning are required. If the obstetric period has reached 9 weeks, then cleaning cannot be avoided. The most common reason for curettage at this stage of pregnancy is stopping the development of the embryo. Some women experience spontaneous miscarriage even without intervention, but in some cases, after the diagnosis is confirmed by ultrasound, the patient is sent for an abortion.

Abortion over 12 weeks always requires the use of drugs that contract the uterus. The myometrium is already sufficiently stretched by the growing fetus, so after a miscarriage or abortion, problems with involution may arise. Women who have concomitant pathologies of both gynecological and extragenital profiles face contraction disorders. Most often, after an abortion, the uterus contracts poorly due to infectious diseases of the genital tract, hormonal imbalance, or the presence of a scar.

If after full-term birth the uterus completely contracts and returns to normal size in 1.5 - 2 months, then after a miscarriage or abortion, its involution is completed by the 14th day after the manipulation. Otherwise, the risk of bleeding increases and medication is required.

What does the uterus look like after an abortion and what can clots, adhesions and erosion of the cervix lead to?

Premature delivery is called abortion.

A distinction is made between spontaneous abortion, that is, miscarriage, and medical abortion , carried out with the help of medications or surgery.

Termination of pregnancy affects primarily the functioning of the female reproductive system.

Moreover, each method of abortion has a different effect on the woman’s condition..

The peculiarity of pharmacological abortion is that it has minimal impact directly on the uterus, having a greater impact on the functioning of the ovaries and causing sudden changes in hormonal levels.
The drug blocks the action of progesterone and stimulates the production of oxytocin .
th begins to actively contract, pushing the fertilized egg out of the organ cavity. After the products of gestation are removed, the uterus becomes smaller.

The uterus and its mucous membrane are not damaged after medical termination of pregnancy.

This contributes to the rapid restoration of the menstrual cycle - within 23-28 days after the intervention.

The woman’s immediate condition during and after an abortion is similar to malaise during menstruation: severe cramping pain in the lower abdomen, profuse bleeding, blood clots in the uterus after an abortion, swelling of the external genitalia due to blood flow.

However, the degree of damage caused varies significantly:

Most often it is carried out at a period of 7-9 weeks, when the embryo has already implanted into the wall of the uterus. With such an intervention, only the area to which the fertilized egg was attached is damaged. After the intervention, the myometrium may continue to contract for 2-3 days, causing pain.

A few days after the operation, the uterus returns to its normal size. In the absence of any inflammatory reactions, the menstrual cycle returns to normal within 30-40 days. Dilatation and evacuation .

It is carried out up to and including the second trimester of gestation. For this intervention, the cervical canal is dilated with the help of antiprogestagenic drugs or prostaglandins. After which the contents of the uterus are removed using a vacuum aspirator.

Since such an operation is performed at a fairly long stage of pregnancy, the uterus remains enlarged in size for some time and is actively contracting. Such spasms of the myometrium contribute to the natural rejection of the mucous layer and its removal from the organ cavity. A woman may experience pain in the lower abdomen, radiating to the anus and external genitalia. Dilation and curettage .

The most traumatic method of abortion.

It is recommended to resort to it only in extreme cases.

To carry out the intervention, the cervical canal is widened using pharmacological drugs or surgical dilators.

After which the doctor scrapes the lining of the uterus, removing gestational products.

This kind of intervention leads to the fact that the entire inner surface of the uterus is an open wound, which is why the woman experiences quite severe pain. Menstruation after curettage is established only after 50-70 days, since the restoration of the mucous layer of the uterus in this case occurs extremely slowly.

Take the contact details of a doctor who you can contact if any symptoms that worry you appear.

The cervix after an abortion is swollen and open. The mucus plug, which is normally located in the cervical canal, protecting the uterus from potential infections, is destroyed. In this regard, a woman after the intervention should be especially careful to avoid the development of inflammatory diseases .

If during an instrumental abortion the mechanism of opening of the cervical canal was disrupted, then trauma to the cervix is possible. As a result, ruptures of the external or internal pharynx may occur. They are manifested by pain, pain in the depths of the vagina or lower abdomen, discharge of scarlet blood and are diagnosed during a gynecological examination.

During curettage, damage to the uterus may occur.

Such injuries include disruption of the integrity of the endometrium and perforation of the uterine wall.:

Endometrial injury is caused by excessive mechanical force on the wall of the organ during curettage, resulting in bleeding, inflammation and suppuration of the uterus.
Perforation of the organ wall with a surgical instrument causes extensive bleeding.

The patient experiences severe pain, weakness, and a sharp drop in blood pressure. With perforation, injury to the bladder and intestines and the development of peritonitis are also possible.

Perforation of the uterine wall is a life-threatening condition.

You can often hear questions like this from women: “Clots in the uterus after an abortion, what should I do?”

Trauma to the uterus during an abortion may have long-term consequences:

Development of adhesive processes . Post-abortion adhesions in the pelvis are most often formed as a result of endometrial trauma during instrumental abortion. Adhesions in the uterine cavity lead to hypomenstrual syndrome and can cause infertility, since the fertilized egg cannot attach to the mucous membrane.
Erosion of the cervix after an abortion occurs as a result of the mechanical impact of surgical instruments or due to hormonal imbalance in the woman’s body. This leads to the replacement of the mucous layer with connective tissue. Erosion in itself is not dangerous, but when exposed to pathogenic factors it can degenerate into malignant neoplasms.
Endometritis is inflammation of the uterine mucosa . Develops as a result of infection entering the uterine cavity. The injured endometrium serves as a favorable environment for the proliferation of bacteria and viruses.
Endometriosis develops due to the spread of endometrial cells to other organs as a result of surgery. Since the uterine tissue is sensitive to hormones, as it grows, it provokes monthly bleeding. This leads to constant inflammatory processes in the affected organs.

All these complications, as a rule, develop after instrumental abortion. That is why the World Health Organization recommends resorting to curettage as little as possible.

How long does the uterus contract after an abortion?
Depending on the abortion method, the uterus contracts from 1 to 3 days .
In some cases, pathological conditions may occur when the myometrium spasms for much longer or does not contract at all.

Such conditions indicate either the persistence of gestational products or the accumulation of secretions in the uterine cavity.

In the first case, additional cleaning and removal of the fertilized egg will be required.

Diagnosis is made by ultrasound examination.

If you are concerned about insufficiently intense or excessive contractions of the uterus, accompanied by pathological discharge, blood clots or bleeding, or if the uterus does not contract at all after an abortion, seek medical help.

In some cases, ultrasound after an abortion may reveal various pathological conditions.:

Residues in the uterus after medical termination of pregnancy are detected on ultrasound as a result of incomplete abortion. Most often, such a pathology occurs as a result of pharmacological abortion for a period of more than 7 weeks.

If parts of the fertilized egg remain in the uterine cavity, then the patient is advised to undergo endometrial curettage. Hypoechoic inclusions after medical abortion may indicate uterine perforation, retention of gestational products, development of endometritis and other pathologies.

A doctor can establish an accurate diagnosis only after a thorough examination, studying the results of an ultrasound scan and conducting a series of tests.

In most cases, an abortion performed by a qualified professional does not have harmful effects on the woman's health . If you are concerned about any pathological symptoms after the intervention, be sure to seek help from your doctor.

Based on materials from prberem.com

Drugs

Immediately after completing any procedure to terminate a pregnancy, doctors place an ice pack on the woman’s lower abdomen. This leads to vasoconstriction, suppression of bleeding and contraction of the uterus. For a healthy woman, cooling the uterine area after a miscarriage is sufficient for its contraction. And also when interrupting a short term, doctors do without the use of drugs.

In later stages of gestation, bladder catheterization is performed to contract the uterus after abortion. Since the uterus and bladder are innervated from the same nerve plexus, overfilling of the latter leads to relaxation of the myometrium. After an abortion, doctors remove urine through a pre-installed catheter.

In obstetrics, three groups of drugs that contract the uterus are used.

Ergot alkaloids (Ergometrine, Methylergometrine).
Oxytocin drugs.
Prostaglandins.

The effect of prostaglandins is due to the fact that the drugs are able to contract the smooth muscles of the uterine body under any circumstances, whereas after natural childbirth, obstetricians more often use oxytocin. The uterus, ready for normal labor, is equipped with a large number of receptors for oxytocin, so if it is hypotensive in the first day after birth, these drugs are used to reduce it. Until the third trimester, the myometrium does not have such a number of receptors, so oxytocin will not perform its functions.

In addition to these drugs that contract the uterus after a miscarriage, a drug called Analgin-quinine is occasionally used, which is not included in the official register of uterotonics, but its use is justified by the necessary mechanism of action on the myometrium.

Prostaglandin preparations

The medicinal representatives of this group are dinoprost (an analogue of human prostaglandin F2a) and dinoprostone (an analogue of prostaglandin E2). Trade names of dinoprost - Enzaprost, dinoprostone - Prepidil gel, Prostenon gel for the cervix. Among the group of prostaglandins, drugs that contract the uterus after a miscarriage or abortion include drugs for parenteral administration (intravenously), which is why Enzaprost is used. Gels are relevant for stimulating labor.

The mechanism of action of the drug is associated with increased contractile activity of the myometrium at any stage of gestation. When the drug is administered, the cervix also opens, which helps empty the organ cavity of clots, remnants of the chorion, placenta, and parts of the fetus.

The most common side effects include intense abdominal pain, vomiting, nausea, increased body temperature, asthma, increased blood pressure, and inflammation of the veins.

A drug such as Misoprostol is used for medical abortion due to its powerful effect on the contractile activity of the myometrium.

Oxytocin preparations

This substance is a pituitary hormone and is widely used in obstetrics to enhance labor, as well as in the postpartum period and after abortion to involute the uterus and stop bleeding.

The mechanism of action of drugs from the oxytocin group is to increase the strength and frequency of contractions due to an increase in the concentration of calcium ions in myocytes. Such drugs are used in the form of intravenous or intramuscular injections and are relevant after a late abortion.

If there is no effect from the hormonal drug, prostaglandins are administered.

The dosage of the drug is as follows: the basis for administration is 10-20 ml of a 40% glucose solution, in which 5-10 IU of the substance is diluted. Administration for contraction of the uterus after miscarriage or abortion is carried out intravenously. A minute later, the woman feels a strong and painful spasm in the lower abdomen. The effect lasts from half an hour to 3 hours.

Side effects include: nausea, vomiting, increased blood pressure, suffocation. Use with caution in women over 35 years of age.

Ergot alkaloids

An extract from the plant has been used in obstetrics for a long time. The main reason for prescribing drugs from this group is considered to be uterine hypotension and associated bleeding. If, when prescribing oxytocin and prostaglandins, they rely on the size of the uterine body after a miscarriage, then ergot alkaloids are used for such a life-threatening condition as bleeding.

The drug is used in the form of Ergometrine tablets, which are prescribed 1-2 pieces 2-3 times a day.

The mechanism of action of this group is associated with increased myometrial tone, the frequency of its contractions, and increased vascular tone. The most common side effects are pain and cramps in the heart, artymia, headache, increased blood pressure, abdominal pain, nausea and vomiting. Alkaloids are toxic substances that, if overdosed, can lead to severe consequences of ergotism. They are prescribed with caution.

Ergometrine is used after a miscarriage or abortion quite often due to its guaranteed action, since during normal childbirth its use is not so relevant due to strong side effects.

Symptoms after an abortion when you should consult a doctor

Increased temperature (more than 37.2 0C) 2 weeks after the abortion, which is not relieved by medications for 2 days or more;
Heavy bleeding that tends to increase. Bleeding after an abortion is an inevitable phenomenon, but it should decrease, and not vice versa;
Blood clots the size of grapes or larger;
Severe pain in the lower abdomen;
Unpleasant and specific vaginal odor;
Long-term continuation of pregnancy symptoms;
blood in stool or urine;
Frequent dizziness, nausea, fainting.

How to relieve pain and cramps

After an abortion, spasmodic pain is constant and can come and go. There is nothing scary about the fact that spasms, cramps and pain accompany the patient in the first two weeks after an abortion.

Recommendations:

To relieve symptoms, it is recommended to take medications such as Paracetamol and Ibuprofen. It is forbidden to take Aspirin, as it tends to increase bleeding.
If there is pain in the lower abdomen, you can place a heating pad or a bottle of warm water wrapped in a towel, which will alleviate the condition.
It is necessary to surround yourself with comfort, tranquility and devote a lot of time to sleep.

Analgin-quinine for contraction

Among the additional drugs that affect the contractile activity of the muscle fibers of the uterine body, the combined drug Analgin-quinine is distinguished. The product consists of two active ingredients with the following mechanisms of action:

Metamizole is a non-steroidal anti-inflammatory drug that reduces pain, inflammation and spasms;
Quinine is primarily an antimalarial drug, but its ability to stimulate uterine contractions has led to the drug being used to accelerate myometrial involution after miscarriage.

The most pronounced effect when using quinine is noted in combination with oxytocin.

When the muscles contract, a sharp spasm of the vessels that nourish the chorion or placenta occurs - this stops the bleeding. In addition, the drug has an analgesic effect, which is important in the period after a miscarriage.

The drug is used in the following dosage: two tablets every 30 minutes - a total of six tablets. Uterine contraction occurs two hours after administration.

It should be borne in mind that metamizole is considered a toxic drug. The drug has a negative effect on hematopoiesis, which limits its use in modern medicine. For pain relief after an abortion, it is better to use new generation non-steroidal anti-inflammatory drugs - Ibuprofen, Diclofenac.

Among the folk remedies that can help the uterus contract after a miscarriage are herbs such as shepherd's purse, barberry, and chistets.

After curettage or vacuum aspiration, the woman needs to visit a gynecologist for an ultrasound scan after 2 weeks. The doctor will assess the condition of the uterine cavity and the rate of contraction. After this period of time, the myometrium should completely shrink, and the uterus should acquire its normal size. The discharge during this period is bloody. If clots or remnants of membranes are detected in the cavity, curettage is performed.

Planning pregnancy allows women to avoid such serious interventions in the body as abortion. If interrupted for medical reasons, you should be under the close supervision of a gynecologist and carry out rehabilitation in accordance with all the instructions of the attending physician. Timely detected and corrected problems in uterine contractions after a miscarriage eliminate problems with conception and pregnancy in the future.

In medical practice, artificial termination of pregnancy is called abortion. After this manipulation, the woman needs to undergo a full recovery. Artificial termination of pregnancy has a negative impact on health and necessarily requires some effort to normalize the functioning of the reproductive organs. Let's take a closer look at what happens after an abortion in the uterine cavity and other reproductive organs.

Possible damage to the uterus

During a surgical abortion, complications of varying severity may occur:

Perforation of the uterus during curettage. This is one of the most dangerous complications and requires immediate medical attention. It usually appears 5-6 hours after surgery. A woman may feel severe pain, and the bleeding will be quite strong;
Uterine rupture. This complication occurs extremely rarely, but it can lead to complete removal of the uterus;
Cervical rupture. A small tear can heal without medical attention, but a scar forms at the site of the tear, which can negatively affect the process of childbirth in the future.
If a woman is undergoing more than her first abortion procedure, the walls of the uterus can become very thin. In the future, when planning a pregnancy, this may lead to the fact that the fertilized egg will not be able to attach to the thin uterine wall.

Such complications are rare when the operation is performed by a qualified doctor with extensive experience in terminating pregnancy.

Uterus after abortion

After an abortion, a woman expects a fairly long recovery period, which largely depends on the method that was used during the procedure, as well as on compliance with all the recommendations of the female doctor. The first thing that happens in the body of a failed mother is the contraction of the uterus and its cleansing of secretions. This process is normal and lasts from several days to a week. During this period, the restoration of the endometrium, the mucous membrane lining the uterine cavity from the inside, begins actively. The duration of complete restoration of the endometrium is about a month, since a wound forms at the site where the fertilized female reproductive cell was attached after an abortion. The fastest recovery occurs after an abortion performed using vacuum aspiration.

picture taken from To Truth

Termination of pregnancy using vacuum aspiration is most often carried out in the period from 7 to 9 weeks of gestation, since during this period the embryo has already managed to attach to the wall of the uterus. If this method is used for abortion, damage occurs only to the area of the uterus where the fetus was directly attached. The duration of the procedure is only a few minutes, while the woman experiences minimal impact. After the manipulation, the myometrium begins to actively contract, causing pain. 5-6 days after surgery, the uterus returns to its original size.

When medications are used for abortion, the recovery period will be quite long. This is because the drugs used to terminate pregnancy are considered safe, but they also have negative effects on the body. For medical abortion, a characteristic pathological phenomenon is a hormonal imbalance, therefore, when using this method, a woman needs to learn about all the possible complications that may arise after terminating a pregnancy in this way.

The longest recovery of the uterus occurs after instrumental or surgical curettage. In addition, this method has a huge number of complications that can arise after the procedure.

Bleeding after medical abortion

After medical termination of pregnancy, cases of bleeding can be observed quite often. During this process, the fertilized egg dies and leaves the uterus. This process quite often leads to bleeding. However, blood loss can be either normal or profuse. At the same time, it is necessary for everyone who undergoes a pharmacological termination of pregnancy to know that bleeding should not continue for more than a month.

If the patient’s blood loss is more than a month, then this is not the norm. Normal bleeding is painless and not profuse. If, after termination of pregnancy, the patient feels a sharp increase in temperature, then an urgent need to consult a doctor. It is he who is able to establish the causes of bleeding after medical termination of pregnancy and prescribe appropriate treatment. In any case, if you feel any discomfort and your general health begins to deteriorate significantly, you should immediately see a doctor. This way you will save yourself from negative consequences and will have the opportunity to relive your pregnancy.

Discharge after abortion

After an abortion, the appearance of moderate discharge with a small amount of bloody clots in it is quite physiological and characteristic of this process. The duration and amount of leucorrhoea largely depends on the method that was used to terminate the pregnancy.

If instrumental abortion is used, the discharge will be more abundant and intense than with vacuum aspiration. This is justified by the fact that when using the latter method, trauma to the uterine cavity is minimized.

When spotting after an abortion has a different consistency, the woman needs to visit a gynecologist who will examine the uterine cavity.

Often, after an abortion, a woman’s general condition is very weakened. The occurrence of weakness is mainly accompanied by bleeding from the uterine cavity, which can last up to two weeks. After their complete disappearance, the woman needs to go to the gynecologist. Prolonged discharge may signal the occurrence of a placental polyp or the remains of a fertilized egg in the uterine cavity. A bad sign is also a rapid cessation of discharge or its complete absence. This picture indicates an unfavorable outcome of the manipulation, because normally a woman’s uterus cannot contract so quickly. The main reason for the rapid end of discharge is often a spasm of the cervical canal, so all the blood accumulates in the uterine cavity and does not come out. In order to eliminate the problem as quickly as possible, medications can be used or the uterine cavity can be re-cleaned.

How long does it take to recover after an abortion?

The period in which a woman can completely return to normal condition, first of all, depends on the quality of the abortion performed, on the patient’s condition before the termination of pregnancy and on the chosen method of rehabilitation.

Another decisive factor is the number of weeks the aborted woman was pregnant: the shorter the pregnancy, the faster the level of placental hormones produced by the body during pregnancy decreases.

It is unlikely that it will be possible to bring the body back to normal in the shortest possible time with expensive drugs. The speed of recovery directly depends on individual characteristics, physical and psychological health.

Full recovery of the body can be expected in six months, after which it will be possible to return to your usual lifestyle - playing sports, lifting weights, traveling and having children.

It is not recommended to plan pregnancy in less than six months.

Pain after abortion

After the manipulation, a woman may feel pain in the lower abdomen, which provokes discomfort, but does not change her usual lifestyle. If the pain becomes stronger, the woman needs to consult a specialist, because severe pain may be a signal of the occurrence of the following pathological processes:

The development of hematometra is an excessive accumulation of blood in the uterine cavity, which can be caused by the remnants of the fertilized egg. In this situation, the pain will be sudden, very sharp and will have a cramping nature.
The occurrence of an inflammatory process caused by latent sexually transmitted infections. Inflammation is often accompanied by aching pain and an increase in body temperature.

When a woman undergoing an abortion is bothered by pain in her back, or more precisely in the lumbar region, the cause of the pain may be excessive physical exertion. We should not forget that a slight nagging pain in the back is a completely physiological phenomenon that is typical for this manipulation.

Restoration of the menstrual cycle

Abortion is a serious stress for the body, so after it the menstrual cycle is almost always disrupted. Normally, in a young and healthy woman, menstruation returns after an abortion in about a month. But it often happens that the duration of the cycle lengthens or shortens, and the nature of the discharge also changes. A scant smudge may appear, and this is explained by incomplete restoration of the endometrium after surgery.

If the restoration of the menstrual cycle after an abortion is accompanied by scanty discharge for quite a long time, it is necessary to be examined. This pathological condition can be caused by the following factors:

Functional failure in the production of hormones by the pituitary gland, ovaries and hypothalamus. This usually occurs after a medical abortion and is associated with taking a large amount of antiprogestin, and therefore hormonal therapy is necessary.
Mechanical damage to the endometrium or cervix. Trauma to the endometrium in the uterine cavity leads to the formation of adhesions in the pelvis, which are rejected during menstruation.

You should also be wary if the restoration of the cycle after an abortion is accompanied by heavy discharge. They may indicate that endometrial hyperplasia or adenomyosis is developing.