Abnormal Bleeding After a D&C

A D&C, also known as a dilation and curettage, is a surgical procedure used to scrape and collect tissue from the inside of the uterus 2. Women undergo this procedure for many reasons including an elective abortion, to diagnose uterine cancer, to treat heavy menstrual bleeding, or to remove remaining tissue following a miscarriage. After the procedure, it is common for women to experience some bleeding. However, abnormal bleeding may indicate that a complication has occurred.

Procedure

A physician may perform a D&C in a hospital or clinic and women may have general anesthesia whereby they are completely sedated, or receive a local anesthetic, which numbs the cervix. During a D&C, the physician inserts an instrument to hold open the vaginal walls for the duration of the surgery. The physician dilates the cervix using a metal rod and inserts a metal loop called a curette into the uterus. The physician then gently scrapes the inner layer of tissue from the uterus. The National Institutes of Health explains that the procedure often takes only a few minutes and women can usually return to normal activity within a few days 3. During recovery, a woman may experience minor cramping and some spotting or light bleeding.

Abnormal Bleeding

While minor bleeding or spotting is normal, heavy bleeding is often an indication that something has gone wrong. Women who experience a gush of blood or feel that they need to change a feminine pad every hour or two, should contact their physicians or go to the hospital immediately, according to the American Pregnancy Association 1.

Causes

Heavy bleeding may occur do to a perforation of the uterus during surgery. The metal instruments can puncture the uterus or other internal organs. In some cases, bleeding occurs after due to hemorrhage or infection.

Prognosis

The prognosis following a complication from a D&C depends largely on how quickly a woman receives treatment, as well as the cause of the abnormal bleeding. Infections often respond to antibiotics, but a perforated uterus requires additional surgery. Women may experience scarring on the uterus that prevents or complicates future pregnancies. In rare cases, death can occur.

Considerations

A D&C is a common procedure and most women do not experience complications. However, it is important to be aware of symptoms that signal complications in order to seek medical treatment if needed. Dizziness, heavy bleeding, cramping, a fever over 100.4 degrees Fahrenheit, chills or a foul smelling discharge are not normal symptoms and women experiencing these symptoms should speak to their physicians immediately, according to the American Academy of Obstetricians and Gynecologists 4.