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"Can an incomplete abortion cause damage to my uterus?"
I had a miscarriage. I am worried none of my babies will stick in the future. Can I ever have a child?
The term miscarriage, also referred to as a spontaneous abortion, is an unfortunate condition wherein a pregnancy ends spontaneously before the fetus has reached a viable level of development. There are many variables to consider when determining the prognosis after a spontaneous abortion. A spontaneous abortion is considered complete when pathologic examination of the passed tissue confirms that it contains all the products of conception (fetal tissue, gestational sac, etc.) An incomplete abortion is a spontaneous abortion wherein all or part of the products of conception are retained after spontaneous termination of a viable pregnancy. Incomplete abortion requires medical intervention or at least close follow up with a physician to prevent bleeding or infection due to the retained tissue. The approaches to dealing with this problem are either surgical (dilation and curettage or dilation and evacuation to remove the retained tissue), medical (using medications to induce contractions and expulsion of retained tissues), or expectant (close observation and waiting for spontaneous passage of retained tissues). Research has shown that these are all acceptable strategies to treat women with incomplete abortion, however some approaches have specific benefits and complications that make them better suited to certain patient populations. With regard to the ability to successfully carry future pregnancies, some helpful data are available. The overall risk of miscarriage in a future pregnancy is approximately 20% in women who have had one prior miscarriage, 28% after 2 miscarriages, and 43% after 3 or more miscarriages. These are general data and specific considerations may modify these probabilities in certain patient populations. For example, in women requiring multiple instances of surgical intervention for incomplete abortion, there is some evidence that intrauterine scar tissue can develop, compromising fertility. This is, however, an uncommon occurrence only affecting a minority of women. The best estimate of the effect of a miscarriage on your fertility and ability to carry future pregnancies can only be accurately determined by an obstetrician who is familiar with your complete medical and obstetric history. There are many factors to be considered, so please speak to a trusted obstetrician, who can analyze these and explain them to you. This can give you an accurate picture of what effect a spontaneous abortion may or may not have on your ability to carry a future pregnancy.
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