Is medication abortion followed by uterine evacuation considered two separate injuries?

Medical abortion, commonly known as medication abortion, and uterine evacuation (also called dilation and curettage, or D&C) are both medical procedures used to manage unintended pregnancies or miscarriages. If a D&C is performed after a medication abortion when no intrauterine remnants are present, it may result in a second injury. However, if tissue remnants remain after the medication abortion, performing a D&C should not be considered a second injury. The detailed analysis is as follows:

If a patient experiences no complications after medication abortion and there are no residual tissues in the uterine cavity, but a D&C is still performed based on medical advice, or if an emergency D&C is required due to complications following the medication abortion, then the medication abortion and the D&C can be regarded as two separate medical interventions. Each intervention may impose varying degrees of physical and psychological burden on the patient.

If during the medication abortion process the gestational sac and decidual tissues have been completely expelled and bleeding has stopped, but a follow-up examination reveals minor residual tissue, the subsequent D&C is primarily intended to remove these remnants and prevent complications such as infection or hemorrhage. In this case, the D&C serves as a corrective measure for an incomplete medication abortion and should not be viewed as a second injury.

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