Scraping of the mucous membrane of the uterus

Any operation is unpleasant and involves a certain risk. But sometimes there are situations when this is the only way out. Scraping of the uterus is one of the gynecological operations that is often performed for medical reasons. What are these cases?

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What is curettage

What is curettage

Scraping of the mucous membrane of the uterus is classified as an operation to remove the mucous membranes of the uterus body and the cervical canal. Scraping in medical practice is used both for diagnostic and therapeutic purposes. For example, with uterine bleeding, polyps of the cavity and cervix, etc. Also, scraping is carried out with the goal of aborting the pregnancy at terms up to 12 weeks. Scraping is prescribed after the forced termination of pregnancy in late terms and in the postpartum period, with incomplete miscarriage. When the placenta is delayed in the uterine cavity, which is the cause of uterine bleeding.

According to the medical definition, the uterus is a muscular organ that resembles a "pear" in shape. Nature in the uterus is provided with a cavity, which through the cervix of the uterus communicates with the external environment. The uterine cavity is covered with endometrial mucosa. During the menstrual cycle, the endometrium thickens. If there is no pregnancy, the shell is rejected by the body. There is a menses. After menstruation, the endometrium begins to grow again.

During the procedure for scraping the mucous membrane, only the endometrium is mechanically removed. The truth is not all the mucous is removed, but only a functional surface layer. After curettage of the uterine membrane, the endometrial growth layers remain, from which a new mucous membrane grows.

Before and after surgery

As a rule, the scraping operation is performed just before menstruation, just a couple of days before its expected start. This is done so that the process of curettage of the uterine mucosa in time coincides with the physiological periods of rejection of the endometrium. On the eve of surgery, the woman is examined by an anesthesiologist. On the day of surgery - an operating obstetrician-gynecologist. A general examination, a study of the vagina and cervix with the help of mirrors and a manual study to clarify the position and shape of the uterus. To exclude complications and identify contraindications to curettage.

The operation is usually performed under general anesthesia (but sometimes under local) in the gynecological chair. The cervical canal is enlarged by means of inserted dilators of different diameters. The whole operation lasts about 15 minutes. After curettage of the patient's uterus, patients spend several hours or days in the hospital. Within 1 month after the operation, one should abstain from sexual activity. It is necessary to observe the doctor in order to avoid complications. These include:

• perforation (violation of the integrity of the wall) of the uterus, infection, the development of inflammation;
• the development of intrauterine adhesions, which can cause a violation of the menstrual cycle and reproductive function.

Within 3-10 days after the operation, sometimes spotting spots appear. Should be alerted if the discharge stopped almost immediately and simultaneously there was a pain in the abdomen. There is a fear that the cervical canal spasms and a hematoma is formed (blood accumulates in the uterine cavity). It is necessary at once to address to the doctor and to pass or take place US. To prevent the development of hematomas, as a prophylaxis in the first postoperative days, you can take a no-shpa 2-3 times a day (1 tablet). Also in the postoperative period, a small course of antibiotics is prescribed - to prevent inflammation and other complications.

Diagnostics

Diagnostic curettage of the uterine mucosa with subsequent examination of the material is carried out with suspicion of dysplasia and cervical cancer, tuberculosis. The same scraping of the uterine membrane is performed for diagnosis in cases where the ultrasound data does not allow an accurate diagnosis:

• With uterine bleeding, arising without signs of pregnancy, infertility and in some other cases.
• If a woman has a long and plentiful menses with the release of blood clots.
• If there are bloody intermenstrual secretions.
• When a woman can not get pregnant for a long time.
• With other, more rare diseases.
• Therapeutic scraping is performed when pathological formations are detected.

The doctor may notice changes in the mucosa on the ultrasound, but it is not possible to accurately diagnose ultrasound in all cases. Sometimes, ultrasound should be performed several times before and after menstruation. This is necessary to determine pathological formations. If the formation remains after menstruation - prescribe curettage of the uterine mucosa.

Also scraping is prescribed to remove the remains of the membranes after childbirth, miscarriage, unsuccessful abortion.

Contraindications

Scraping of the uterine mucosa is contraindicated when:

• acute infectious diseases, exacerbation of chronic diseases of internal organs;
• acute and subacute inflammatory diseases of the genitals;
• suspicion of perforation (disruption of the integrity of the wall) of the uterus.

In emergency cases (for example, with severe bleeding in the postpartum period), contraindications may not be taken into account.

Scraping the mucous membrane of the uterus can diagnose a number of serious diseases, interrupt unwanted pregnancy. However, this is an unsafe operation with possible complications.