Retained Products of Conception
It happens in approximately one in 100 STOPs. The symptoms are usually abdominal (menstrual) pain, heavy or prolonged bleeding or passing blood clots. This happens when tissue remains in the uterus and may require a repeat curette or the use of medication. We will do this at no extra cost.
You should contact the clinic if you are bleeding heavily or bleeding for more than two weeks.
Infection
Some patients (1:200) may develop an infection in the fallopian tubes or the uterus. The symptoms are a temperature over 38C, sweats, pain and excessive or prolonged bleeding. If treated early with antibiotics, infection has no after effects. However, if treated too late, in rare cases, it can cause infertility.
There is a debate among doctors about the use of antibiotics. They can have side effects and dangerous allergic reactions. However, there is evidence that their use reduces the incidence of post STOP infection. At the end of the operation, while you are still asleep,a metronidazole suppository (flagyl) will be inserted in your rectum. (Patients having local anesthetic do not have this treament.) You will also be given a script for Azithromycin (Zithromax). Take these two tablets with dinner on the day of the operation. Azithromycin is a long lasting antibiotic. Both Flagyl and Zithromax are safe for breastfeeding. Contact the clinic if you are concerned that you may have an infection.
Perforation of the Uterus
During the operation, a small hole can be torn in the soft uterine wall (approx 1:1000). Usually, the uterus repairs itself and only needs observation at the clinic or a hospital. Occasionally, the tear will have to be surgically repaired. In very rare cases a hysterectomy is required.
Excessive Bleeding
Very heavy bleeding may occur during the STOP (approx1:5000) and you may be admitted to hospital for surgery or a blood transfusion. Very rarely, a condition called Disseminated Intravascular Coagulation may stop your blood from clotting. If this happens you will be admitted to intensive care in the closest major hospital. This is more likely to occur in mid trimester patients and is a life threatening condition. It can also occur during pregnancy.
Clot Retention
Blood clots may remain in your uterus. The symptoms are increasing pain without bleeding. The treatment is repeat curette.
Cervical Stenosis
Some patients (1:500) may develop a small scar at the opening of the uterus which stops blood from passing. Usually, this is easy to treat at the clinic. A very rare condition called Aschermann’s Syndrome may occur where the scarring is more extensive and may cause untreatable infertility.
Continuing Pregnancy
If a pregnancy is very early the STOP may fail (1:1000). If pregnancy symptoms persist for more than one week after the STOP or if you don’t get your period after eight weeks, contact the Clinic. If you are still pregnant another STOP can be performed. A urine pregnency test can be positive up to four weeks after a succesful termination.
Ectopic Pregnancy
About 1:200 pregnancies develop in the tubes and not in the uterus. If you have an ectopic pregnancy you will be admitted to hospital for treatment. Ectopic pregnancies are very serious and may cause death. If we think you are at risk we have a special information sheet which you will be given.
Psychological Disturbances
Major emotional or psychological problems after a STOP are uncommon. They are more likely if you have a pre-existing problem or are pushed into a STOP against your will. The clinic can arrange a referral to appropriate counsellors if necessary.
