D&C  is a medical procedure done to remove tissues from  inside of the uterus. It is usually done after a  first trimester miscarriage. Dilation means opening up of the cervix with medication or small instruments. Curettage is the removal of the uterine content. This may be done by scraping the walls of the uterus with a suction curettage  ( also known as vacuum aspiration) or using a vacuum type instrument.
 

 

Why is D&C done after a miscarriage ?

It is done after a miscarriage to stop abnormal bleeding. A D&C may also be recommended for women who miscarry after 10 – 12 weeks because these people may need the procedure for miscarriage to be complete. Some women may also want this procedure to get a miscarriage over and done with rather done waiting for their body   to do it naturally.

What are the risks associated with a D&C ?

D&C  is usually safe but as with any procedure , complications are possible. Complications of a D&C include the following :

• heavy bleeding or hemorrhage
• perforation of the uterus
• problems with anesthesia such as adverse reactions or breathing problems
• scarring of the uterus and cervix
• weakening of the cervix
• infection of the uterus and pelvic organs

How is a D&C done ?

This could be an inpatient or outpatient procedure which is usually done under general anesthesia even though  IV anesthesia or paracervical anesthesia may also be used

1. Antibiotics may be given through an IV or orally to prevent infection.
2. The cervix is evaluated. If it is closed, dilators are used to open it so that surgical instruments can pass through. A speculum is then placed to keep the cervix open.
3. During the vacuum aspirator procedure, a plastic cannula (a flexible tube) is  attached to a suction device to remove the uterine content. A curette (sharp edged loop) may also be used  to scrape the lining of the uterus even though this is not often used.
4. The content of the uterus is then  sent to the pathology lab for testing.
5. When the uterus becomes firm and bleeding minimizes, the doctor will send you to recovery

What to expect after the procedure ?

Most people are discharged a few hours after a D&C . However  if you had any complications, you will stay a bit longer. You may be given an antibiotic to prevent infection and pain medication to help with cramping.

How do you take care of yourself after a D&C ?

These tips can help you care for yourself after a D&C

• bleeding and light cramping are expected over a few days to a couple of weeks. Ibuprofen can be used to treat these cramps
• do not insert anything into your vaginal including sexual intercourse and douching for at least 2 weeks or until bleeding stops. NOTE : You health care provider will give you specific instructions about sexual intercourse
• you should not use tampons until you start your regular menstrual cycle which will be in about 2 -6 weeks after the procedure
• you should use a method of contraception once intercourse is allowed to prevent pregnancy until your doctor says it is okay to conceive
• most women return to normal activities within  24 hours to a few days
• make sure to attend follow-up appointments

 
NOTE
 
See your health care provider immediately if :

• pain intensifies
• you experience dizziness or fainting
• you bleed or cramp  for over 2 weeks
• you have fever over 100.4 °F
• you have foul-smelling vaginal discharge

 
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