Miscarriage: Why a curettage?
Miscarriage - the diagnosis is a shock to any woman. After all, is always bad to lose a child. Often gynecologists advise then to a curettage, but the curettage or curettage is not always medically necessary. What women should know before deciding for or against a curettage.
Curettage - informed before you decide
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Melanie B. hit the message out of the blue. After a positive pregnancy test, she went cheerfully to the check-up with her gynecologist. Then the shock: the ultrasonic was indeed to see the gestational sac, but it can be seen only a stunted embryo with no heartbeat. In the subsequent consultation, the doctor advised Melanie to decide at rest between two options. As the young woman was pregnant until the sixth week, and very often the case there in early pregnancy, that the fruit is expelled by itself with a strong bleeding, she could just wait. Doctors call it a "complete miscarriage", Alternatively, they can also opt for a curettage (curettage) that removes the parts of the lining of the uterus, placenta and pericarp from the uterus.
"I found very word curettage awful. The idea that a doctor doing out scratching my baby really that I wanted in no case", The young woman recalls. Together with her friend and her twin sister, she thought in the days that back and forth and decided finally to be seen. "I have the time between diagnosis and then five weeks later onset of bleeding, needed to leave me alone from my child. That was hard, but I wanted to put me mourning. After a curettage I would be the same proceeding to life again, that did not feel right for me to"Says Melanie B. After the blood flow to her gynecologist then controls the value of the pregnancy hormone hCG. "This doctor and patient to make sure that no remnants of the fruit or pericarp remaining in the uterus"Explains the Cologne gynecologist Margit von Scherenberg. hCG value does not decrease significantly even after a hemorrhage from a curettage must be carried out after all.
When is a curettage after a miscarriage inevitable?
Despite the good prognosis for a "natural miscarriage" However, other women make a conscious decision for the surgery. You can not stand for weeks to wait for the bleeding and pull it instead a terminlich fixed line under the sad chapter of an unsuccessful pregnancy. But there are also cases where a curettage is medically advisable. As a remnant of the placenta is retained even after a period in women who've been in the eighth to twelfth week of pregnancy, often in the uterus back and makes a curettage necessary.
"Moreover, caution should always be exercised when women complain of severe, more than a week long lasting and very painful bleeding. In such a case, a curettage is usually inevitable"Explains the gynecologist Margit von Scherenberg. Necessary or advisable a curettage is often when a so-called molar pregnancy has formed: The egg was then fertilized indeed, but is it developed no embryo.
Curettage usually an outpatient procedure
The curettage itself is a short surgical procedure of less than 15 minutes, which takes place under general anesthesia. Most of the intervention takes place on an outpatient basis in a practice or hospital and the woman must after surgery there remain no more than a few hours for observation. The patient then takes on the gynecological chair course and get a general anesthesia. The physician expands their cervix to get access to the uterus and there to remove the remains of the embryo and the placenta and the uterine lining. This infections or persistent bleeding can be prevented. For this, the doctor either used or dull a sharp-edged, spoon-like instrument with which it scrapes off the upper layer of the endometrium. The engagement with a sharp spoon is called in the technical language abrasion, the engagement with the blunt spoon curettage.
Bleeding after curettage: What's normal?
In the days after the procedure light bleeding are normal, which usually subside quickly. Not normal these days are more bleeding, fever and pain; with such complications the woman should seek medical attention. In the first three weeks after curettage a waiver of swimming, saunas, sex and tampons is advised because the cervix is slowly closes again and germs can penetrate into the uterus otherwise. Like any other surgery is required even when curettage a time to recovery. So many women report that they then felt tired and worn a few days, a not uncommon reaction to the anesthesia, but also to the engagement of the uterus.
What are the risks curettage?
Although it is a routine procedure, but it can happen in very rare cases that the doctor violated the uterine wall during surgery yet. Such wounds usually heal without complications, although again, but can also leave scarring. If the doctor has accidentally pierce the uterine wall, germs can penetrate into the abdominal cavity and cause inflammation. Other possible complications were infection of the wound and a cervical weakness. This poses a risk to subsequent pregnancies.
As soon pregnant again after curettage?
Exactly when the next ovulation occurs after a curettage, you can not accurately predict. At about the time of four to eight weeks after the procedure normally takes the next period one, but the woman can get pregnant again before this bleeding. If a couple so not right after a miscarriage is planning a new pregnancy, it should think about prevention in time. In the past, doctors have pairs often advised to wait to get pregnant are at least three months after a miscarriage, because otherwise they feared an increased risk of a renewed miscarriage. But this concern is now to be unfounded, as a long-term study by the University of Aberdeen has proved. Accordingly, a new pregnancy itself is the surest sign that the female body is ready to carry a child. Nevertheless, every couple should decide for themselves if it still wants to wait or not. After all, not only the body takes a while to recover. The soul needs to draw a baby time to grieve and to courage.
After curettage: How high is the risk of a renewed miscarriage?
Bleeding after menopause: More reasons for curettage
If a woman has menopause already behind and usually no longer period, it can still cause bleeding, which then have to be medically investigated. Also it is often made a curettage, and then in more detail to examine the tissue from the uterus. Sometimes the last part of a birth does not run very smoothly, the placenta is not completely expelled and the uterus does not contract properly together. This can also make a curettage necessary.
curettage is sometimes confused with the so-called ablation, an engagement, are to be removed in the fibroids and polyps. In ablating the endometrial lining to be in the deep layers in deserted. In a curettage however, only the upper layers of the uterus to be removed and can build up again after the procedure. Also in the course of the menstrual cycle, the upper layer of the mucous membrane is repelled in the uterus during the menstrual way, and then builds up over the course of four weeks again.