suction curettage

Artificial abortion (artificial abortion) because of the unexpected pregnancy of contraceptive failure, artificial measures taken in the early pregnancy to terminate it. Treatment of diseases: early pregnancy Indication 1. Those who are required to terminate the pregnancy within 10 weeks of pregnancy. 2. Not suitable for continuing pregnancy due to various chronic diseases. Contraindications 1. Acute or severe systemic diseases of various diseases require hospitalization after treatment is improved. 2. Acute inflammation of the reproductive organs, severe cervical erosion or obvious purulent secretions in the vagina. 3. Pregnancy spit has not corrected acidosis. 4. The body temperature was above 37.5 °C twice before surgery. Have a history of sexual intercourse within 5.3 days. Surgical procedure 1. Position: The patient takes the bladder lithotomy position, routine vulva and vaginal disinfection, and puts the sterile hole towel and leg sleeve. The surgeon performs double examination and checks the size, position and double attachment of the uterus. The cervix was exposed with a vaginal speculum, 2.5% iodine and 75% alcohol to disinfect the cervix. 2. Detecting the uterine cavity: The surgeon first clamps the front lip with a cervical clamp and then pulls it with the left hand. The right hand uses the uterine probe to detect the depth of the uterus and marks the probe with the fingertip. Generally 6 to 8 weeks of pregnancy, the depth of the uterine cavity is 8 ~ 10cm; 9 to 10 weeks of pregnancy, the depth of the uterine cavity is 10 ~ 12cm. 3. Dilatation of the cervix: The pendulum is used to extend the cervix in the direction of the uterus, and generally expands from the beginning of the 4th to the larger than the selected number or number one. 4. Straw suction: connect the straw, enter the vacuum suction test is correct, select the straw thickness and negative pressure according to the gestational age, use the 5 to 6 straw for less than 7 weeks, the negative pressure is 53.2kpa (400mmhg); 7 to 9 weeks Use 6 to 7 straws, negative pressure is 53.2 ~ 66.5kpa (400 ~ 50-0mmhg); 9 ~ 10 weeks 7 ~ 8 straws, negative pressure is 66.5 ~ 73.1kpa (500 ~ 550mmhg), negative pressure should not exceed 79.8kpa (600mmhg). The straw is sent to the bottom of the palace and then retracted 1cm. The side hole of the straw is directed to the front or back wall of the uterine cavity to find the embryo. The placenta attached to the placenta has a sponge-like feeling, and then the tissue is sucked into the tube, generally in a clockwise or counterclockwise direction. Move up and down to attract the uterine cavity for 1 to 2 weeks to attract the pregnancy. The signs of suction are: (1) The pipette head is tightly attached to the wall of the uterine cavity. (2) The uterine cavity is reduced by 1.5 to 2.0 cm. (3) There is a bloody foam in the cervix. 5. Clean up the uterine cavity: If you suspect that there are still fluff and decidua not sucking, you can use a small curette to scrape the uterine cavity, and gently send a small curette into the bottom of the palace, starting from the left cervix angle counterclockwise ring scraping 1 ~ 2 weeks can be. 6. Check the aspirate: pay attention to the presence or absence of fluff and embryo, whether the villi are intact, the ratio of villus to decidua is generally 1:3~4, if no fluff or scrape is too small, b should be super-reviewed, and ectopic pregnancy should be excluded again. All aspirates were sent to a pathological examination to confirm the diagnosis. complication 1. Bleeding: bleeding more than 200ml, older with pregnant women, more times, more than 3 months of pregnancy, negative pressure is not absorbed into the bed, the surgeon is not skilled. The oxytocin should be injected into the cervix 10~20u, and the placenta should be taken as soon as possible to remove the uterine tissue. Postpartum can be given 30g, 2 times / day for a total of 3 days. 2. Abortion syndrome (A-S syndrome): related to the expansion of the cervix over-speed or jump number and excessive negative pressure, pregnant women often have nausea, vomiting, chest tightness, dizziness, pale, cold sweat and other symptoms. Give intramuscular injection of atropine 0.5mg intramuscularly or 654-2 anisodamine 20mg intramuscularly, inhale oxygen, and recover spontaneously after 10min. 3. Sucking: If the suction is found, the operation should be stopped immediately, b-reviewed, and the ectopic pregnancy should be strictly prevented, and the minimally absorbed tissue should be sent to the pathological examination. 4. Leakage: It is prone to occur in very early pregnancy, early uterus with excessive flexion or flexion, and undiagnosed abnormal uterus. 5. Incomplete abortion: Part of the villus or decidual tissue was not aspirated, and the bleeding was continued for more than 1 week after the operation. The blood volume exceeded the menstrual period. The b-review of the uterine cavity still had a light group reflex. The uterus should be treated with antibiotics. 6. Uterine injury: including uterine perforation and cervical laceration and failure to detect the size, location or breast-feeding uterus of the uterus before surgery, the direct force is directly related. If the probe is perforated and there are no obvious symptoms, follow-up is performed for 1 to 2 weeks, and the perforation is self-healing before surgery. If it is a perforator or a straw, it should be hospitalized and, if necessary, exploratory. Such as cervical laceration, according to the size and depth of the laceration, with gauze pressure to stop bleeding or No. 1 chrome gut suture to suture the full layer of the cervix. 7. Excessive suction: Destruction of the basal layer of the endometrium, formation of menorrhagia or amenorrhea, artificial cycle therapy. 8. Infection: If the postoperative temperature exceeds 38 ° C, acute inflammation should be hospitalized. 9. Infection of the uterine cavity and neck tube: the suction time is too long, the suction tube rotates too fast, the frequency is too high, the negative pressure is too high, and the force is too large, there may be different degrees of periodic lower abdominal pain, using the 5 to 6 dilator Separate the adhesion, discharge the menstrual blood in the uterine cavity, in order to prevent re-adhesion, place the metal IUD, and return to the normal menstrual period after 3 cycles.

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