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Threatened Miscarriage (cont.)

Surgery

The dilation and curettage procedure (D&C) involves dilating the uterine cervix so that the lining tissue (endometrium) of the uterus can be removed by scraping or suction.

The D&C is a safe procedure that is done for a variety of reasons. It is minor surgery performed in a hospital or ambulatory surgery center or clinic. D&C is usually a diagnostic procedure.

Therapeutic dilation and curettage: A D&C is often planned as treatment when the source of the problem is already known. One situation is an incomplete miscarriage or even full-term delivery when, for some reason, the fetal or placental tissue inside of the uterus has not been completely expelled. If tissue is left behind, excess bleeding can result, perhaps even life-threatening bleeding.

Your health care professional will avoid D&C in the following situations, except when absolutely necessary:

  • Pelvic infection: If you have an infection involving the reproductive organs, there is a chance the surgical instruments that will enter the vagina and cervix can carry the bacteria from your vagina or cervix into your uterus. There is also an increased risk of injury to infected tissue. For these reasons, the doctor may prefer to wait until after the infection is cleared up with antibiotics before performing the D&C.
  • Blood clotting disorders: Doctors depend on the body's natural ability to clot to stop bleeding after curettage. Women with certain blood disorders are usually not given this surgery.
  • Serious medical problems: Heart and lung disease, for example, can make general, and sometimes local, anesthesia more risky.
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