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Pregnancy | Your Wellbeing

What is a D&C – Dilation and Curettage?

Even though it’s hard enough having to deal with all the emotions you go through after a miscarriage, you’ll want to make sure that you avoid excessive blood loss and prevent infection. In the case of an incomplete miscarriage you’ll need to empty the uterus surgically with a D&C procedure.

In most cases, however, women miscarrying in the first trimester of pregnancy who are otherwise stable (with no fever or excessive bleeding) can choose to have non-surgical treatment. You can wait and see if your miscarriage progresses over days, weeks or even months – to complete itself. In this case you’ll eventually need your gynae to use ultrasound to confirm that all pregnancy tissue has been passed from your uterus. Another option is taking medicines which can cause the uterus to contract and empty – but this takes longer than surgical treatment and can be painful and have bad side-effects. And it’s not always effective, which means you might end up needing surgical treatment after all.

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What is a D&C and why is it necessary?

Dilation and curettage refers to the dilation of the cervix and the surgical removal of the contents of the uterus – assisting women in managing a miscarriage that is causing severe bleeding. It is a therapeutic gynaecological procedure, and the first step in a D&C is to dilate the cervix – often done a few hours before the surgery. The woman is usually put under general anaesthesia before the surgery begins, and then a curette – a metal rod with a handle on one end and a sharp loop on the other – is inserted into the uterus through the dilated cervix. The curette is used to gently scrape the lining of the uterus and remove the remaining pregnancy tissue. This tissue is then examined for completeness. The procedure usually takes about 10-20 minutes, and you won’t have to stay in hospital overnight.

What are the advantages of having a D&C?

There are a few advantages of having a D&C that are worth pointing out. First of all, on the emotional side, it helps you get over a miscarriage faster. Most miscarriages occur in your first pregnancy trimester, but your body might only expel the foetus three months later, and waiting for this to happen can be traumatic. A D&C completes and ends the miscarriage without dragging out a painful incident any longer than necessary. On the physical side, because a D&C completes a miscarriage faster, it shortens the amount of time you experience bleeding, cramping and other symptoms of a miscarriage.

What are the risks involved with a D&C?

Although very rare, especially with the increased use of suction over actual scraping, there are some risks involved with having a D&C. They include possible reactions to anaesthetic medicines, infection and puncture of the uterus.

  • The risk of sharp curettage is uterine perforation. Although normally no treatment is required for uterine perforation, a laparoscopy may be done to verify that bleeding has stopped on its own.
  • Infection of the uterus or fallopian tubes is also a possible complication, especially if the woman has an untreated sexually transmitted infection.
  • Another risk is intrauterine adhesions, or Asherman’s syndrome. One study found that in women who had one or two sharp curettage procedures for miscarriage, 14-16% developed some adhesions. Women who underwent three sharp curettage procedures for miscarriage had a 32% risk of developing adhesions.

How soon can I have sex after a D&C?

The recovery period following a D&C is short, and most women are able to return to work and other normal activities within one or two days. During the recovery period, however, you might experience:

  • Mild pelvic cramping
  • Small amounts of vaginal bleeding
  • A slight vaginal discharge

You might also find that your next period will be early or late, and you should stay away from intercourse, douching and the use of tampons for at least two weeks.

References:
www.pregnancytoday.com
www.wikipedia.org
www.webmd.com

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