Patient's question:
Medical Description: On August 8, 2010, uterine bleeding occurred. Treatment and Effect at Qing Shui Hospital: Received progesterone injections and took progesterone medication, but bleeding still occurred. Desired Help: I want to know if it's a problem that I still have blood?Doctor's answer:
1. Threatened AbortionRest in bed and avoid sexual intercourse. For patients with luteal phase deficiency, progesterone therapy can be administered. During treatment, monitor changes in patient symptoms and test results, and perform ultrasound examinations if necessary to confirm fetal development. Before starting treatment to prevent miscarriage, it is essential to rule out ectopic pregnancy (extrauterine pregnancy).
2. Inevitable Abortion and Incomplete Abortion
Once confirmed, the embryo and placental tissue should be completely expelled as soon as possible. In early pregnancy, if inevitable or incomplete abortion occurs, vacuum aspiration should be performed promptly. Carefully examine the miscarried tissue and send it for pathological examination. In late pregnancy, uterine contractions should be promoted to ensure the complete delivery of the fetus and placenta. After delivery, check whether the placenta and membranes are completely expelled. If necessary, perform a curettage to remove residual products of gestation. In cases of excessive vaginal bleeding, complete laboratory tests, and if needed, blood transfusions, fluid resuscitation, and anti-shock treatment. For prolonged bleeding, antibiotics should be administered to prevent infection.
3. Complete Abortion
If there are no signs of infection, no treatment is usually required. Ultrasound examination can be performed to confirm whether there is any residual tissue in the uterine cavity.
4. Missed Abortion
Artificial abortion is typically performed. If the embryonic development has stopped for an extended period, and the gestational tissue is tightly adhered to the uterine wall, surgery may be difficult and may lead to severe bleeding due to abnormal coagulation function. Before treatment, blood tests (including complete blood count, coagulation time, and platelet count) should be conducted, and blood transfusion preparations should be made.
5. Abortion Infection
This often occurs in incomplete abortion with infection. The treatment principle is to actively control the infection. If vaginal bleeding is not significant, intravenous broad-spectrum antibiotics should be used, followed by a thorough curettage after infection is controlled. If septic shock has already developed, shock should be actively corrected. If the infection is severe or abscesses have formed in the abdominal or pelvic cavity, surgical drainage should be performed, and if necessary, the uterus should be removed.