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Evacuation Method Of Abortion Done Under General Anesthesia. How To Know That Total Evacuation Is Done?

Posted on Fri, 13 Jul 2012

Question: the doctors have performed evacuation method of abortion successfully where i am 5 weeks under general anesthesia, i am not bleeding heavily.
in this method the abortion is done 100% effectively so there will be nothing left out inside?
they did not right any further rescan
how will the doctors know that there is nothing left inside
will they perform this by watching the monitors in operation theater like how laproscopy i s done,so that they can know taht nothing is left

Answered by Dr. Neelam Ashish Vanjari (2 hours later)

Hi,

Thanks for writing in.

Ultrasound is done before and during the procedure of surgical dilatation and curettage (D&C) to know the size of fetus in uterus. After procedure the, uterine products (products of conception) that are removed are observed to know whether or not evacuation is completed completion of evacuation.
An ultrasound scan will be performed at this stage to confirm it.

Your doctors may have followed the same procedure while you were in the operating theatre.

Besides this, one would have symptoms of heavy bleeding, abdominal cramps, vaginal discharge associated with incomplete abortion. Absence of these symptoms is again against the possibility of incomplete evacuation.

So there is no need to repeat a scan. It would be needed if you develop the aforementioned symptoms.

I hope I have answered your query. In case of doubt, I shall be happy to help you.

Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Neelam Ashish Vanjari (2 hours later)

sine i am 5 weeks the fetus is very small they will remove the fetus by bursting inside or as a single piece it will come out by using surgical instruments
they did not show me anything after procedure
should i have asked?
they told it is done successfully?

how many days after the symptoms of incomplete abortion will arise?

even if very very very very small pregnancy tissue is left over inside uterus it will cause infection? and all the above symptoms mentioned of incomplete abortion with
will arise. my parents told me that u will have high fever also if the abortion is incomplete is that true?

even if very very very small pregnancy tissue is left over inside the urine test will show positive or negative done at home

Answered by Dr. Neelam Ashish Vanjari (16 hours later)

Hi,

Thanks for writing in.

As you mentioned, yes, fetal mass is very small at 5 weeks pregnancy; and D&C is much easier at 5 weeks when compared to later pregnancy. Hence the chances of incomplete evacuation are less. It is likely that your doctors have curetted it successfully and would have confirmed on ultrasound.

That being said, dilatation and curettage is procedure of choice in 2nd term of pregnancy i.e. after 12 weeks; medical termination is the preferred method of termination at 5th week. I am curious to know if you were told any specific indication to go for this procedure / whether or not you tried medical pills for abortion.

Symptoms of incomplete abortion can develop in a weeks’ time; even if very, very small piece of product of conception were left behind, you would still develop the symptoms and infection.

High grade fever suggests presence of infection -but not sufficient to suggest incomplete abortion. Rather constitution of all above mentioned symptoms may indicate presence of incomplete abortion. I would suggest you to report back to your treating doctor / get a repeat scan if you develop heavy bleeding, severe abdominal cramps, vaginal discharge, high grade fever and so on.

Following termination of pregnancy as the fetus is dead, hCG hormone levels come down gradually. Your home pregnancy test need not be positive if there were any products left behind. However a positive test indicates incomplete abortion / new pregnancy.

I understand your apprehension. If there is any anxiety / suspicion about incomplete abortion, you may plan to get a repeat ultrasound scan. This will put all your fears and apprehensions to rest and solve your problem.

I hope I have cleared your doubt. In case of other doubts feel free to revert back. Do close this discussion if you have no other queries.

Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Neelam Ashish Vanjari (4 hours later)

i am suggested to go with this because of tender scar since its just 5 months since my c section is done they have given me option
then i asked which is better they said sometimes medical abortions are not successful then how ever u have to go with this ,so opt this at once everything will be finished.they asked me for recheck up at 12,but not rescan,may be if i complaint these symptoms they will do it

i dont have any such kind of symptoms at present since its only 3 days
but i am worried .
are there any chances of piece left behind but no such symptoms will develop?

if repeat scan tells that there are some left behind what will they do again generally?

the symptoms will develop after 1 week only but not after 2 weeks or sooo

Answered by Dr. Neelam Ashish Vanjari (37 minutes later)

Hi,

Thanks for writing in.
Your treating physician has taken right decision of evacuation procedure because you have c-section history.

Even if small piece remains in uterus; you will get symptoms of abdominal cramps or fever as it becomes focus of infection and body tries to expel it at the same time.
So you will usually get symptoms in that case. Usually symptoms will start appearing in 1 week time. If you do not get symptoms in 1-2 weeks; it indicates procedure as successful.

In case of left pieces, doctor will prescribe you tablets to expel the product. There is no need of repeat procedure.

I hope I have cleared your doubt. In case of other doubts feel free to revert back.
Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Aparna Kohli