The purpose of menstrual regulation is to perform early abortion, not to restore menstrual regularity. By using a manual vacuum pump and a small suction tube, this technique is relatively simple and has its complications.
The term “menstrual regulation” was used in Vietnam during the 1970s to refer to cases of uterine suction after a delay of 7-10 days or more, which may include either pregnancy or no pregnancy within the uterus. At this stage, the embryo is referred to as a fertilized ovum that is organizing to form an embryo, not yet resembling a fetus; colloquially, it can be described as a “drop of blood still in the watery egg stage,” which causes less stigma compared to late-stage abortions.
Some studies indicate that only about 80% of cases of menstrual regulation are actually pregnant. The aim of this technique is to perform early abortions, not to regulate menstruation. However, this term has been widely misunderstood, leading to misuse; whenever menstruation is delayed by 7 days or more, there are recommendations or directives to perform uterine suction immediately, which can lead to many negative consequences for women.
First and foremost, it must be understood that, regardless of how simple the procedure may be, it is a intervention in the human body, and individual reactions vary. Additionally, inserting an object through the cervix can trigger a reflex that may cause sudden cardiac arrest and death. This risk increases if the patients do not receive proper counseling and pain relief.
It is not always the case that a woman ovulates on a specific day just because she has a regular menstrual cycle; ovulation may occur a few days later than expected, leading to late fertilization. Therefore, if uterine suction is performed too early, the embryo may not have descended into the uterus, and it may take a few days post-suction for the embryo to move to the uterus and still develop into a fetus. Such cases are referred to as “wind suction.” Sometimes, the egg is still moving in the fallopian tube, and intervention in the uterus can disrupt this movement, causing the egg to stop and resulting in an ectopic pregnancy. Thus, uterine suction should not be performed to regulate menstruation. If there are menstrual irregularities, a specialist consultation should be sought for appropriate recommendations.
While menstrual regulation is a straightforward procedure, there remains a risk of retained placenta causing prolonged bleeding, which can lead to infections in the uterus due to bacterial contamination. Furthermore, even with proper sterilization, the suction tube must still be inserted, allowing bacteria from the cervix to enter the uterus and cause infection. The fluids within the uterus, which include blood, serum, endometrial tissue, and small fragments of degraded embryonic tissue, create a highly favorable environment for bacterial growth, leading to endometrial inflammation. This inflammation can spread to the fallopian tubes, potentially causing narrowing or blockage, resulting in infertility. Additionally, the suction procedure can perforate the uterus, and in some cases, it can even puncture the intestines or rupture the bladder.
Early abortion is only performed when ultrasound shows that the gestational sac (amniotic sac) is located within the uterus. However, ultrasound may not be available in all regions, so at a minimum, patients should use a pregnancy test kit early on to confirm pregnancy.
Dr. VƯƠNG TIẾN HÒA (Health & Life)
