Why is it generally recommended to perform a uterine evacuation after medication abortion?

Generally, it is recommended to perform uterine evacuation after medical abortion mainly for easier surgical operation, reduced complications, improved efficiency of uterine clearance, management of incomplete abortion, and lower risk of infection. If there are any concerns, it is advisable to seek medical consultation in advance. The detailed analysis is as follows:

1. Easier Surgical Operation

Medications used in medical abortion, such as mifepristone and misoprostol, can soften the cervix and dilate the uterus, allowing surgical instruments easier access to the uterine cavity, thereby avoiding pain and tissue damage associated with mechanical cervical dilation.

2. Reduced Complications

Uterine evacuation following medical abortion reduces cervical stimulation caused by procedures like dilation, lowering the risk of complications such as cervical canal adhesions. Additionally, pre-treatment with medication helps terminate the embryo and loosen embryonic tissues, preventing injury during evacuation that might occur if the gestational sac is firmly attached to the uterine wall.

3. Improved Efficiency of Uterine Evacuation

Medical abortion helps loosen embryonic tissue and its associated products, enabling the surgeon to quickly and accurately remove residual materials from the uterine cavity, thus improving the efficiency of the evacuation procedure.

4. Management of Incomplete Abortion

When a medical abortion fails to completely expel embryonic tissue, some remnants may remain in the uterus. In such cases, doctors may recommend a surgical evacuation. This procedure effectively removes residual tissue, helping prevent infection and excessive bleeding.

5. Lower Risk of Infection

Performing uterine evacuation after medical abortion can reduce the likelihood of intrauterine infection to some extent. However, sexual intercourse should be avoided shortly after the procedure to prevent recurrent uterine infections.

Besides the above, post-abortion uterine evacuation may also promote uterine recovery, prevent infections, control abnormal bleeding, and help preserve women's health and fertility. After the procedure, patients should ensure adequate rest—initially resting in bed for at least 1–2 days, gradually increasing activity afterward, while avoiding strenuous exercise and heavy physical labor for at least two weeks.