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 continued.Help Needed: I want to know if it's a problem that I still have bleeding?
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 symptoms and test results, and perform ultrasound examinations if necessary to assess fetal development. Before starting treatment to prevent miscarriage, it is essential to rule out ectopic pregnancy (ectopic 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 miscarriage, uterine contractions should be induced to ensure complete delivery of the fetus and placenta. After delivery, check whether the placenta and membranes are completely expelled. If necessary, perform a (Dilation and Curettage) to remove residual pregnancy products. In cases of excessive vaginal bleeding, complete laboratory tests, and administer blood transfusions, intravenous fluids, and shock treatment if necessary. For prolonged bleeding, antibiotics should be given 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 pregnancy tissue is tightly adhered to the uterine wall, it may cause difficulties during surgery and 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. After infection is controlled, a thorough (Dilation and Curettage) should be performed. If septic shock has developed, it should be actively corrected. In cases of severe infection or the formation of abscesses in the abdominal or pelvic cavity, surgical drainage should be performed, and the uterus may need to be removed if necessary.