When you need a stationary format
When the pregnancy is more than 8-10 weeks, the volume of tissue is larger and the risk of bleeding is higher - infusion support, uterotonics and longer observation are necessary; the same for bleeding that has already begun, anemia, coagulation disorders, chronic diseases (heart, diabetes), Rh-negative blood (administration of anti-Rhesus immunoglobulin). After the procedure, the patient is in the ward under control of her condition and discharge, a control ultrasound is performed, antibiotic prophylaxis is prescribed, and she is discharged home in the evening. The resulting material is sent for histology and, if necessary, genetic research to determine the cause of pregnancy loss.
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.
