Dilation and Curettage (D&C) (cont.)

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The following are risk factors of dilation and curettage:

• Hemorrhage: Heavy bleeding is rare, but it can happen if an instrument injures the walls of the uterus. It also can occur if an undetected fibroid is cut during curettage.
• Infection: There is always a slight possibility of infection once instruments are inserted into the uterus. Most infections can be easily cured with antibiotics.
• Perforated uterus: This complication, though rare, is more common in women who have a uterine infection at the time of the procedure, in elderly postmenopausal women, and if the procedure is being done for a miscarriage. If the doctor suspects this condition has developed, the patient may be asked to stay in the hospital for observation or further surgery.
• Asherman syndrome: This complication is rare and involves the formation of scar tissue in the uterus, caused by aggressive scraping or abnormal reaction to the scraping. Thick scars can result, which can fill up the uterus completely. This can lead to infertility and cessation of menstrual periods.
• Missed disease: Since the procedure cannot completely remove all the endometrium (lining tissue of the uterus), there is a chance that disease could go undetected. This is why the procedure is seldom done without a hysteroscopy (examination of the uterine lining using an instrument that allows direct visualization ).

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