Does an embryonic arrest require a dilation and curettage?

Written by Zhang Lu
Obstetrics
Updated on April 17, 2025
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According to the different intervention methods, surgical abortion is needed during an abortion procedure, while medical abortion might not be necessary. Embryonic arrest, also known as missed abortion, occurs during pregnancy due to various factors which result in the absence of a fetal heartbeat in the gestational sac or fetus. Most cases of embryonic arrest occur during early pregnancy. If no fetal heartbeat is observed by the 9th week of pregnancy, it is diagnosed as embryonic arrest. Once embryonic growth ceases, it is crucial to intervene artificially as soon as possible to expel the gestational sac from the uterus. Common methods of artificial intervention include medical abortion and surgical abortion. If surgical abortion is chosen for an embryonic arrest, it involves direct curettage or evacuation of the uterus. Embryonic arrest can also be treated with medical abortion, which involves taking oral medication to stimulate uterine contractions, soften the cervix, and expel the gestational sac from the uterus. A follow-up is required about two weeks after the abortion. If there is no residual material in the uterine cavity, then curettage is not necessary; however, if substantive residuals or blood signals are present inside the uterine cavity, then curettage is needed.

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Written by Zhang Lu
Obstetrics
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Can a miscarried embryo be expelled naturally?

Embryonic arrest refers to the lack of natural development of the gestational sac in early pregnancy, characterized by the absence of a fetal heartbeat. If there is still no fetal heartbeat or embryo detected during an ultrasound at 8-9 weeks of pregnancy, it should be diagnosed as embryonic arrest. After embryonic arrest occurs, the vast majority require medical intervention. Of course, some cases of embryonic arrest can resolve naturally, leading to a miscarriage. However, this is not a reliable occurrence and is relatively rare in clinical practice. Moreover, the longer the wait, the greater the potential harm to the woman's health. For embryonic arrest, once diagnosed, it is urgent to intervene medically to remove the gestational sac from the uterus, minimizing harm to the woman. Common methods include medical abortion or a dilation and curettage surgery, either of which can be chosen.

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Written by Liu Wen Li
Obstetrics
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What happens if there is embryonic arrest without miscarriage?

If an embryo stops developing but is not miscarried, the retained embryonic tissue can disrupt the clotting function in the pregnant woman’s body over time, leading to a condition called a missed miscarriage. Therefore, after a missed miscarriage occurs, it is important to check the duration it has been retained. If it has been a considerable amount of time, clotting function should be examined. If clotting is still within normal ranges, it is crucial to expedite the process allowing the woman to expel the non-viable embryonic tissue as soon as possible, which is beneficial for her health.

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Written by Du Rui Xia
Obstetrics
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Why does embryonic arrest cause back pain?

After the embryo's development stops, the uterus will induce contractions, leading to pain in the lower back and abdomen, which is considered normal. Following the cessation of the embryo's development, there will be episodic pain in the lower abdomen accompanied by back pain, primarily to facilitate the process of embryo cessation and to promote the expulsion of the gestational sac. In such cases, it is important to rest, observe the expulsion of embryonic tissue, and be mindful of vaginal bleeding. Rest should be prioritized, avoid overexertion, strengthen nutrition, maintain a regular routine, and, if necessary, undergo a uterine cleaning procedure.

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Written by Du Rui Xia
Obstetrics
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What will happen if a miscarried embryo is not removed from the uterus?

After embryonic arrest occurs, it is necessary to handle it promptly, which involves expelling the embryo from the body. If the embryo remains for an extended period without timely intervention, it can easily lead to an infection in the uterine cavity, or even sepsis. The fetus may adhere to the uterine wall, making it difficult to clean later and can easily cause severe bleeding, seriously endangering the patient's life. Therefore, once we identify that an embryonic arrest has definitely occurred, it is crucial to undergo prompt uterine cleaning treatment. It is advisable to communicate with the hospital doctors and take appropriate measures.

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Written by Zhang Lu
Obstetrics
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Is embryonic arrest related to emotions?

Embryonic arrest refers to a condition during early pregnancy, around 9-10 weeks, where no fetal heartbeat is detected. In clinical practice, there are many causes of embryonic arrest, including chromosomal abnormalities, uterine malformations, infections, immune factors, and coagulation factors. However, many women do not investigate these reasons after experiencing embryonic arrest. Instead, they look for causes in their daily lives, such as dietary factors or emotional factors. In reality, embryonic arrest is generally not closely related to everyday life factors. Even if emotions fluctuate, such as becoming irritable or easily provoked, which might affect the gestational sac, such impacts usually manifest as symptoms of threatened miscarriage, but generally do not lead to embryonic arrest. Therefore, there is generally no correlation between embryonic arrest and emotional states.