How to prevent bleeding after abortion

Factors that affect the amount of bleeding during artificial abortion (abbreviated as induced abortion) include, in addition to the suction technique, the operator's age, gestational age and uterine cavity size.

1. The embryo or fetus and its appendages are not completely sucked out or some tissue remains after scraping out, affecting uterine contraction.

2. Poor uterine contraction. Multiple abortions or other reasons leading to poor uterine contraction.

3. Uterine injury such as uterine perforation, cervical laceration, etc.

4. Coagulation disorder such as severe liver disease, blood disease, thrombocytopenia, etc.

5. The placenta is attached low and blood flows out every time the uterus dilates.

6. Cervical pregnancy or lower uterine pregnancy is rare. If the diagnosis is not clear before the operation, curettage may lead to heavy bleeding.

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1. Rapidly remove residual tissue in the uterine cavity. If bleeding is found, in addition to intramuscular injection of uterotonic agents, the type of suction tube and the size of negative pressure should be adjusted to quickly remove residual tissue in the uterine cavity. Bleeding often stops quickly, which is one of the keys to hemostasis.

2. Treatment of poor uterine contraction

(1) If the contents of the uterine cavity have been scraped clean, the suction or curettage should be stopped. The uterine contraction agent should be injected quickly. If necessary, 20-30U of oxytocin can be dripped intravenously to maintain uterine contraction.

(2) If conditions permit, prostaglandin preparations such as PGF2a can be injected (for those without contraindications).

(3) Massage the uterus: Use your fingers to massage the uterus from the abdomen, or use bimanual massage and pressure on the uterine body to promote uterine contractions and control bleeding.

(4) If necessary, a 0.5-1.0 mg suppository can be placed in the posterior vaginal fornix, which can often achieve good results.

3. If uterine perforation occurs, conservative treatment or laparotomy can be performed depending on the condition of the perforation.

4. Cervical laceration can be treated with compression or suture to stop bleeding.

5. Patients with heavy bleeding should take measures to replenish fluids and expand blood volume in a timely manner, and blood transfusions should be performed if necessary. Antibiotics should be used after surgery to prevent infection.

6. For patients suspected of cervical pregnancy or lower uterine segment pregnancy by ultrasound, curettage and dilatation should be performed after uterine artery embolization.