Is it necessary to have a uterine curettage if there is residual material in the uterus but no bleeding after a spontaneous abortion?

If there is residual material in the uterus after a spontaneous abortion, whether or not to perform uterine curettage has little to do with bleeding. It mainly depends on the amount of residual material, the level of human chorionic gonadotropin (HCG) in the blood, the results of B-ultrasound examination, and the general physical condition. If there is a lot of residual material and HCG continues to rise, uterine curettage is necessary. Otherwise, medication can be used for treatment.

1. How much residue there is: An ultrasound examination after a miscarriage may reveal residues with an average diameter of less than 20 mm and no blood flow signals. This may be decidua residue. You can take some blood-activating and blood-stasis-removing drugs under the guidance of a doctor, such as: Motherwort Paste, Acanthopanax Biochemical Capsules, Guizhi Fuling Capsules, etc., which can promote uterine contraction and help discharge residues.

2. Blood human chorionic gonadotropin (HCG) status: HCG test is still relatively high. Combined with the results of B-ultrasound examination, if there is a blood flow signal, a uterine curettage is required.

3. B-ultrasound examination results: B-ultrasound shows that the residues have abundant blood flow signals, which are generally suspected to be villous residues. In this case, uterine curettage is required. Drug treatment generally cannot achieve the best therapeutic effect.

4. If the amount of bleeding is heavy, the uterus should be cleaned at any time: There will be no bleeding for a short time after a miscarriage, but there will be residues in the uterus and heavy bleeding may occur at any time. If the bleeding is heavy and there are blood clots, the uterus should be cleaned at any time.

5. General physical condition: If abortion is accompanied by fever, lower abdominal pain, and suspected inflammation, uterine curettage is not advisable for the time being and anti-inflammatory treatment is needed first.

Generally, uterine curettage has little to do with vaginal bleeding, because some people have more residue but no bleeding, while others have less residue but continuous bleeding. Therefore, bleeding is not used as a diagnostic criterion for uterine curettage. Whether uterine curettage is necessary depends on the doctor's advice.