Causes and treatment of complications after artificial abortion

The treatment of complications after abortion is as follows:

(1) Comprehensive reaction to artificial abortion: refers to the cardiovascular symptoms such as tachycardia, arrhythmia or shock symptoms that occur during or at the end of the operation.

1) Causes: ① Local stimulation and pain of the cervix and uterus during the operation cause vagus nerve excitement, coronary artery spasm, cardiac conduction dysfunction, and a series of cardiovascular symptoms. ② It is related to factors such as the operator's mental tension, difficulty in cervical dilation, too many suction times, excessive negative pressure, uterine contraction, and rough surgical operation. ③ Existing cardiovascular diseases, epilepsy, anemia, and asthma are easily induced.

2) Treatment: ① If the above symptoms are found, stop the operation immediately, lie flat, and breathe. Most mild cases can recover. Pay attention to blood pressure and pulse. ② If blood pressure drops or heart rate is too slow, immediately inject atropine 0.5~1mg to block the vagus nerve reflex and treat the symptoms. ③ If the operation has not been completed, gently clean the uterine cavity after the symptoms disappear.

(2) Uterine perforation

1) Causes: ① Misdiagnosis of uterine position or failure to straighten the cervix, resulting in the instrument entering in the wrong direction and causing accidental injury. ② Inappropriate and excessive force, such as excessive force on difficult cervical dilation or excessive negative pressure during suction.

2) Treatment: ① If danger signs of uterine injury are found, the operation should be stopped immediately and the patient should be examined and diagnosed. The treatment should be decided according to the perforation and whether the organs are damaged. ② For simple uterine perforation, the injury area is small, there is no internal bleeding or organ damage, and the operation has been completed, the patient should be kept in the hospital for observation, antibiotics and uterotonics should be used, and the patient can be discharged from the hospital if there is no abnormality in 3 to 5 days. ③ If the operation for simple uterine perforation has not been completed, an experienced operator should avoid the perforation site and suction the uterus, preferably under B-ultrasound monitoring. ④ If the perforation area is large and the location is unknown, surgery should be performed immediately. During laparotomy, a detailed examination must be conducted to determine whether there is any damage to other organs, and proper treatment should be given. ⑤ If organ damage is not discovered in time and there is a serious infection, the infection should be controlled, the general condition should be improved, surgery should be performed as appropriate, and the superior should be reported in a timely manner.