When undergoing an abortion, especially a dilation and curettage procedure, the doctor must insert instruments into the uterus to remove the fetus. If the cervix is dilated too widely or torn by the instruments, subsequent pregnancies are at a higher risk of miscarriage.
The method of suction curettage has seen significant improvements, but it still involves using metallic instruments to dilate the cervix; metal rods are used to probe and measure the length of the uterine cavity. Additionally, doctors must use a metal suction tube to extract the embryo and the placenta, and a metal curette to scrape the uterus clean. From start to finish, metallic instruments are inserted and removed, which can cause scratches on the uterus and even create tears.
When the placenta is suctioned out from the uterine wall, many blood vessels may rupture. If the placenta is not quickly removed, uterine contractions can be affected, potentially preventing the blood vessels from sealing, leading to significant blood loss. If the patient has untreated pelvic inflammatory disease or if the procedure is not performed under sterile conditions, these instruments can introduce bacteria into the uterine cavity, resulting in infection.
Moreover, suction curettage can lead to complications, especially in cases of multiple procedures:
Uterine Adhesions: Excessive suctioning can damage the basal layer of the endometrium, causing the membranes to stick together, which affects sperm mobility and can make it difficult for a fertilized egg to implant or may lead to miscarriage. Damage to the uterine lining can also cause menstrual irregularities, such as reduced menstrual flow, irregular bleeding, or prolonged amenorrhea.
Infertility: Inability to conceive due to inflammation of the fallopian tubes. If the procedure is not performed under sterile conditions, inflammation can spread from the endometrium to the fallopian tubes, causing adhesions and blockages that prevent sperm and eggs from meeting.
Miscarriage or Preterm Birth: During an abortion, especially a dilation procedure, the doctor must use instruments to extract the fetus. If the cervix is torn during dilation, there is a risk of miscarriage after 12 weeks in subsequent pregnancies.
Placenta Accreta or Deep Implantation: If the uterus is excessively scraped or if the procedure is repeated too often, the endometrium can be damaged and thinned. In subsequent pregnancies, the endometrium must shed its basal layer to accommodate the embryo. If the uterine lining is poorly developed, the villi on the outside of the embryo may implant too deeply, potentially invading the muscle layer beneath the uterine membrane. Consequently, the placenta formed may not easily detach from the uterine wall. As a result, during childbirth, the deeply implanted part of the placenta may not fully separate, affecting uterine contractions and causing significant bleeding. In cases where the placenta is implanted too deeply, a hysterectomy may be the only option to save the mother.
