Faites. Ne faites pas devant une amenorrhee apres I.V.G.
Auteurs : Achard BDate 1985 Mai, Vol 13, Num 5, pp 766Revue : Contraception, fertilité, sexualitéType de publication : article de périodique;Suggestions are offered for treatment of postabortal amenorrhea. In the absence of bleeding immediately after the procedure, a careful gynecological examination should be conducted to determine the size, consistency, and sensitivity of the uterus and the suppleness and vacuity of the lateral cul-de-sacs. A sonogram should be obtained if the results are abnormal, and a plasma dose of human chorionic gonadotropin should be administered after 12 days in case of doubt. If the sonogram suggests retained uterine contents a 2nd uterine evacuation should be carried out and appropriate antibiotic treatment should be initiated. The possibility of unsuccessful abortion must be considered, as must that of placental retention, hematoma, or ectopic pregnancy. A 2nd intervention should be carried out without hesitation if necessary. In the case of secondary amenorrhea more than 4 weeks after the intervention, a complete gynecological examination should be conducted, a serum human chorionic gonadotropin pregnancy test should be administered, incipient adhesions should be sought through X-ray or laparoscopy and perhaps removed, and symptoms appearing after the abortion, such as insomnia, irritability, weight loss, or consumption of drugs should be investigated. The possibility of another pregnancy should be investigated, adhesions should not be allowed to develop, and the possibility of psychogenic amenorrhea resulting from ambivalence about the abortion should be considered.