Outpatient LDV during missed miscarriage
After confirmation of the diagnosis (absence of heartbeat during repeated ultrasound, discrepancy between the size and the term) and examination (tests, smear, blood type), the procedure is performed under short-term anesthesia: the canal is expanded, the fertilized egg is removed with a vacuum aspirator and, if necessary, a curette, the cavity is checked by ultrasound or a hysteroscope. The outpatient format is suitable for up to 8–10 weeks and no bleeding or complications. The tissue is sent for histology (if desired, for genetic research to determine the cause). Bloody discharge continues for up to 7–10 days; control ultrasound in a week; planning the next pregnancy 3–6 months after the examination.
Indications
- endometrial hyperplasia, polyps, abnormal uterine bleeding, bleeding during menopause - diagnosis and stop of bleeding;
- non-developing (frozen) pregnancy, incomplete miscarriage, remnants of the fertilized egg;
- suspicion of endometrial pathology in preparation for operations and IVF;
- fibroids with bleeding - assessment of the endometrium before treatment.
Security and control
Curettage is performed under short-term intravenous anesthesia and takes 15–30 minutes; the modern standard is control by hysteroscopy before and after, in order to remove all contents and not injure the cavity, and during pregnancy, vacuum aspiration, which is less traumatic for the endometrium. The resulting tissue must be examined histologically (in case of a missed miscarriage, with the possibility of genetic analysis). Complications (perforation, infection, synechiae) are rare if the technique and prevention are followed; recovery of the cycle - after 4-6 weeks.
