Consequences of uterine injury post-abortion: What are common occurrences?
Surgical abortions, while generally safe, can occasionally lead to complications such as uterus damage and Asherman syndrome. Here's what you need to know about these conditions and their potential signs and symptoms.
Surgical abortions, when performed in medical settings, rarely result in damage to the uterus. However, it's essential to be aware of the possible complications, including uterine perforation, scarring, and infections.
Uterine perforation, a type of injury to the uterus, can cause heavy bleeding and is a medical emergency. Symptoms of uterine perforation may include moderate to severe vaginal bleeding lasting days or weeks, pelvic or lower abdominal pain and cramping, fever, vomiting, diarrhea, excessive bleeding potentially soaking through two thick sanitary pads per hour for two hours, and possible uterine perforation symptoms or cervical damage, which can lead to complications with future pregnancies.
Asherman syndrome, a rare condition, can develop after dilation and curettage, a type of surgery used to end a pregnancy. This syndrome is characterised by the formation of scar tissue inside the uterus, which can fuse the uterine walls, reduce space, and impair menstruation and fertility.
Symptoms of Asherman syndrome may include reduced menstrual flow (hypomenorrhea) or absent periods (amenorrhea), irregular menstrual cycles or light bleeding, pelvic or uterine pain, infertility or recurrent pregnancy loss due to reduced uterine cavity space caused by scar tissue, and sometimes no symptoms, but diagnosed in women undergoing infertility evaluation or after repeated uterine procedures like dilation and curettage (D&C).
It's important to note that the risk of developing Asherman syndrome is higher if a person has had three or more abortions. The symptoms of Asherman syndrome take time to develop and will vary depending on the amount of scar tissue that grows.
After an abortion, typical side effects people can experience include cramping, bleeding that is similar to a period, and passing of blood clots. If a person received anesthesia or pain medication, they should avoid driving or operating machinery until the following day.
If a person experiences unusual symptoms after an abortion, such as excessive bleeding, severe pain, signs of infection, or symptoms of uterine perforation or Asherman syndrome, they should contact the clinic or the doctor who performed the procedure immediately. Severe symptoms that require immediate medical attention include excessive bleeding, severe abdominal pain or cramping that does not respond to pain medication, symptoms of infection, weakness, dizziness, or fainting.
Heavy or persistent bleeding and severe pain are not typical for several weeks after an abortion; seek medical help if these symptoms develop or if a person has symptoms of infection. It's also crucial to avoid using tampons, having sexual intercourse, and going swimming after the procedure to reduce the chance of infection.
In a 2021 study, the incidence of Asherman syndrome was found to be low in people who had a surgical abortion before the 20th week of pregnancy. Abortion is not the only potential cause of Asherman syndrome - infections and other factors can also contribute.
In summary, watch for abnormal bleeding, pelvic pain, menstrual changes, or fertility problems after surgical abortion, as these may indicate uterine damage or Asherman syndrome requiring evaluation by a healthcare provider. Most people can return to their usual activities the next day after an abortion, but those who have undergone dilation and evacuation or experienced complications may need longer to recover.
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