Cervical Stenosis After Abortion: Causes and Concerns

Cervical stenosis after abortion?

Hello Doctor, I underwent a surgical abortion due to a non-viable fetus last week.
The day after the procedure, I noticed a significant decrease in menstrual bleeding.
During my follow-up appointment this week, the doctor informed me that there was retained blood in my uterus due to cervical stenosis caused by the procedure, which prevented the menstrual blood from flowing out.
The doctor performed a slight cervical dilation in the clinic to allow the blood to exit and prescribed antibiotics and uterotonics.
My question is, I did not have any issues with cervical stenosis prior to this; could this have been caused by the surgical abortion procedure damaging my cervix? Additionally, after the darker blood was expelled during the clinic visit, I noticed that there was none the following day.
Is this normal? Thank you!

Qi, 40~49 year old female. Ask Date: 2018/02/13

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Last week, I underwent a surgical abortion due to fetal demise.
The day after the procedure, I experienced very little menstrual bleeding.
During my follow-up appointment this week, the doctor informed me that there was blood accumulation in the uterus, which was caused by cervical stenosis resulting from the procedure, preventing the menstrual blood from flowing out.
The doctor performed a slight cervical dilation in the clinic to allow the blood to exit and prescribed antibiotics and uterotonics.
My question is, I did not have any issues with cervical stenosis prior to this; could this have been caused by damage to the cervix from the abortion procedure?
Answer: Blood accumulation in the uterus is due to cervical stenosis; I will refrain from commenting further.
Additionally, on the day of the clinic visit, I had dark-colored menstrual blood flow, but it stopped the next day.
Is this normal?
Answer: Yes, this is normal.

Reply Date: 2018/02/13

More Info

Cervical stenosis after an abortion can be a concerning issue, particularly when it leads to complications such as retained blood in the uterus. Understanding the causes and implications of this condition is crucial for managing your health effectively.

Cervical stenosis refers to the narrowing of the cervical canal, which can occur for various reasons, including surgical procedures like dilation and curettage (D&C) performed during an abortion. During such procedures, the cervix is often dilated to allow instruments to access the uterus. This manipulation can sometimes lead to scarring or changes in the cervical tissue, resulting in a narrowed canal. While many women do not experience cervical stenosis after an abortion, it can occur, especially if there was significant trauma to the cervix during the procedure.

In your case, the fact that you did not have a history of cervical stenosis prior to the abortion suggests that the procedure may have contributed to the development of this condition. The accumulation of blood in the uterus (hematometra) due to the inability of menstrual blood to exit through the narrowed cervix is a common consequence. This situation can lead to discomfort, increased risk of infection, and other complications if not addressed promptly.

The treatment you received, which included cervical dilation to allow for the passage of blood, is a standard approach to relieve the symptoms associated with cervical stenosis. The use of antibiotics and uterotonics (medications that help the uterus contract) is also appropriate to prevent infection and promote the expulsion of retained blood.

Regarding your concern about the dark-colored blood you experienced after the dilation, it is not uncommon for menstrual blood to appear darker, especially if it has been retained for a period of time. Darker blood typically indicates older blood that has taken longer to exit the body, which can happen when there is a blockage like cervical stenosis. The absence of bleeding the following day can also be normal, as the uterus may need time to adjust and expel any remaining blood.

It is essential to monitor your symptoms closely. If you experience severe pain, fever, or an unusual discharge, you should contact your healthcare provider immediately, as these could be signs of infection or other complications. Additionally, follow-up appointments are crucial to ensure that the cervical canal remains open and that there are no further complications.

In summary, while cervical stenosis can occur as a result of surgical procedures like abortion, it is manageable with appropriate medical intervention. Your healthcare provider will guide you through the recovery process and monitor your condition to prevent any long-term issues. Regular follow-ups and open communication with your doctor will be key in ensuring your reproductive health remains intact.

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