An incomplete abortion occurs when some pregnancy tissue remains in the uterus after a pregnancy has ended, whether through a spontaneous miscarriage or an induced abortion. This common complication requires medical attention.
What It Means
An incomplete abortion occurs when the uterus does not fully expel all products of conception, which can include fetal or placental tissue. This can happen after a spontaneous miscarriage or an induced abortion. Normally, the uterus contracts to push out all pregnancy-related tissue, but in an incomplete abortion, this process is unsuccessful.
The reasons for incomplete expulsion vary. Sometimes, the body may not recognize that all tissue has been expelled, or uterine contractions might not be strong enough to clear the uterus completely. It can occur in any pregnancy loss, whether spontaneous or induced.
Recognizing the Indicators
Persistent or heavy vaginal bleeding is a primary indicator, lasting days or weeks and potentially accompanied by blood clots or tissue. Abdominal pain or cramping, ranging from mild to severe, is another common symptom.
Additional symptoms can include fever, chills, or a foul-smelling vaginal discharge. These symptoms suggest inflammation or infection within the uterus. While some bleeding and cramping are expected after any pregnancy loss, a worsening or prolonged course of these symptoms requires medical evaluation.
Confirming the Diagnosis
Medical professionals diagnose an incomplete abortion through a combination of clinical assessment and imaging. A physical examination, including a pelvic exam, helps assess the cervix and determine if it is open or if tissue is visible. The healthcare provider will also review the individual’s symptoms and medical history.
Ultrasound imaging is the primary diagnostic tool used to confirm an incomplete abortion. Both abdominal and transvaginal ultrasounds allow healthcare providers to visualize the uterus and identify any retained tissue. Blood tests, specifically monitoring human chorionic gonadotropin (hCG) levels, can also provide supporting information. While hCG levels typically decrease after a pregnancy ends, a slow or insufficient decline can suggest retained tissue.
Pathways to Resolution
Once an incomplete abortion is diagnosed, several management options are available, with the choice depending on the individual’s condition and preferences.
One approach is expectant management, where the body is given time to naturally expel the remaining tissue. This option is generally considered when the retained tissue is minimal, and there are no signs of infection or excessive bleeding.
Medical management involves using medication to help the uterus expel the tissue. Misoprostol is commonly prescribed for this purpose, as it induces uterine contractions. This method offers a non-surgical alternative and has shown high efficacy.
Surgical management is another effective option, typically involving procedures like Dilation and Curettage (D&C) or Manual Vacuum Aspiration (MVA). D&C involves dilating the cervix and using a curette to gently scrape the uterine lining to remove remaining tissue. MVA uses a handheld suction device to remove the tissue. Surgical intervention is often recommended if there is significant retained tissue, heavy bleeding, or signs of infection, or if expectant or medical management are not successful.
Aftercare and Well-being
After the resolution of an incomplete abortion, follow-up care is important to ensure complete recovery. This typically includes additional ultrasound examinations or continued monitoring of hCG levels to confirm that all tissue has been expelled and the uterus is returning to its normal state. hCG levels usually decrease significantly within days to weeks after the procedure, often becoming undetectable within four to six weeks.
Physical recovery involves managing expected symptoms like bleeding and cramping, which may continue for several days to a few weeks. Light activity can usually be resumed the day after a procedure, but strenuous activities should be avoided. To prevent infection, it is generally advised to avoid inserting anything into the vagina, including tampons, and to abstain from vaginal intercourse for about two weeks.
Beyond physical recovery, emotional support and mental well-being are also important. Experiencing an incomplete abortion can lead to a range of emotions, including sadness, grief, or anxiety. Seeking support from trusted friends, family, or professional counselors can be helpful in processing these feelings. Resources are available to provide non-judgmental support and guidance during this time.