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D&C AFTR MISCARRIAGE. Please read before posting D&C q's


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#1 Freckles

Posted 10 February 2009 - 12:27 PM

D&C after Miscarriage
Unfortunately many women require a D&C after a miscarriage. This document aims to answer some of the commonly asked questions about D&C’s and what to expect afterwards. If you have questions that haven’t been answered please post below and let us know.

PLEASE NOTE: While we make every effort to ensure that this information is accurate it cannot replace a consultation with your doctor, midwife or other health professional. They are the only ones qualified to offer specific advice on your particular situation. If you have any concerns please see a health professional immediately.

A good place to start is the EB article on miscarriage.

What is a D&C?
D&C stands for Dilatation of the cervix and Curettage of the uterus. That is a medical term that means the cervix (entrance to the uterus) is enlarged (dilated) and the lining of the uterus is scraped away (curetted). The uterine lining may also be suctioned out, also known as suction curette or suction D&C. Another term used for a suction D&C is D&E (dilatation of the uterus and evacuation of the uterus).

Why is a D&C performed?
In the context of this document, a D&C is performed after a woman had has an incomplete miscarriage. This means that the baby has died in the uterus and the body has failed to expel it, or has only partially expelled it.

What are the risks of D&C?
- Heavy bleeding or haemorrhage
- Infection
- Perforated uterus: this occurs when the curette punctures the wall of the uterus
- Incomplete curettage, resulting in left over products of conception, placenta or other tissues being left behind
- Asherman’s Syndrome: a very rare complication in which scarring inside the uterus can interfere with your menstrual cycle and stop further periods occurring, rendering you infertile

When can I expect to get my period after a D&C?
Menstruation should occur by 12 weeks after the D&C. IF you have not had a period by then you should see your doctor.

Is there anything I need to avoid after a D&C?
- Do not use tampons until your first period after the D&C. This is because your cervix is open after the operation and can more easily transmit infection.
- You should not have sexual intercourse for 2 weeks after the D&C and until all bleeding has ceased. Again this is due to infection risk.

When can I try to conceive after a D&C?
There is some anecdotal evidence to suggest that there is a slightly higher risk of miscarriage if a pregnancy occurs before the first normal menstrual cycle after a miscarriage or D&C. Wait until you have one normal menstrual period and then you can begin trying again on that cycle.

What will my period be like after a D&C?
There is really no ‘normal’ for the first period. It can be: [list]
- Very heavy (but not enough to make you feel faint)
- Very light (but more than spotting)
- Terribly crampy or not at all
- Be heavy initially, then drop quickly to spotting
- Spotting for several days, then heavy after that

The following bleeding is not normal and is not considered a menstrual period:
- Light spotting that only spots for days on end
- Light spotting that comes and goes
- Heavy bleeding that makes you go through a pad every hour or 2 for more than a week

If you are concerned about heavy bleeding please see a doctor or go to your local hospital’s emergency department immediately.

Essential Baby Support Articles
Advice on coping with a miscarriage
Women’s experience of miscarriage
Helping a friend who has suffered a loss

Links to Websites with Miscarriage and D&C Information
www.pregnancyloss.info/
emedicinehealth.com – D&C article
medicinenet.com D&C article
www.womens-health.co.uk/miscarriage.asp



The document last updated 9 February 2009.

Many thanks to babyg1 for her assistance in writing this document, as well as her idea to have it in the first place!

Once posts with questions/information have been processed I will delete them, to try and keep this tidy.

#2 eeyorebaby

Posted 10 February 2009 - 03:10 PM

Looks good - is it worth mentioning the term missed miscarriage under Why is a D&C performed?

I also think it might be worth adding a section about testing the baby to try to determine what went wrong.  We were thankful to know why it happened and what the chances were of it happening again.  It also provided more information on the sex of the baby etc which can help with adjustment.

Another section on what happens to the baby after the d&c.  My hospital gave me written information as I was leaving about what they do with the remains, however I was in no state to read it or comprehend it because it wasn't brought to my attention what it actually was - it was just handed to me as a bunch of paperwork from the hospital.  I still feel guilty to this day that it took me weeks to read their literature which advised the timeframes I had available to instruct them on what to do with the remains.  I don't even know in my particular instance if there were any remains as the forms were just generic.  I do know however that the ashes would be scattered over their baby rose garden at the hospital.  At the time, it really didn't even occur to me that there would be remains.  I was just a few days shy of 12 weeks.

Edited by eeyorebaby, 10 February 2009 - 03:11 PM.


#3 babyg1

Posted 18 February 2009 - 02:41 PM

Hi Emma,

I forgot to put in what bleeding is like after a d&c is done what is normal what is not.  

But basically this website here explains this part of it.

Danni

Edited by babyg1, 18 February 2009 - 02:43 PM.


#4 mel7676

Posted 07 July 2015 - 07:27 AM

Unfortunately, I would like to extend the list of what can go wrong.

On 3rd June I had my first D&C after a missed miscarriage at 12 1/2 weeks.
Retained products - 2nd D&C 6th June.

2 wks later - in hospital on IV antibiotics for infection and endometritis (NOT endometriosis).

2 wks later again (Just this weekend gone, I was in hospital- AGAIN)- IV antibiotics and ultrasound shows a uterus mass. Endometrial lining a whopping 31mm.  Cannot operate again so soon after 2 D&C's and not being sure on what it is.
Given Misoprostol over the weekend in hospital in case the mass is retained product. Nothing happened at hospital, but a few hours back at home, whilst I was sleeping I bled VERY badly in bed and passed a handful of either clots/product/tissue. (took it back to hospital, and awaiting results)

Tomorrow (Wednesday) will be 5 weeks of bleeding every single day. This is not spotting.

Follow up scans/blood test/early pregnancy bleeding unit.
Regular beta HCG testing, as still at 436. (not new pregnancy)

I'm being checked for -
AVM (Very rare, but my ultrasounds can not rule this out, need specialised scan next week)

GTD - Explained chemo to treat. If my HCG levels don't go down, this will be most likely.

RPOC - still after 2 D&C's

I never in my wildest dreams would have thought a D&C/miscarriage could end up to cancer, a uterine AVM.

5 weeks on.......... still bleeding.
UPDATE - Bled for 11.5 weeks, ended up having a 3rd D&C/hysteroscopy for RPOC.

Edited by mel7676, 30 August 2015 - 11:14 AM.


#5 Lisa G L

Posted 19 July 2015 - 01:32 PM

Should post D & C issues be added?

I had 2 D & C procedures 6 weeks apart, 17/4/14 following late miscarriage due to placenta abruption of my son at 14 weeks, this was caused from the placenta implantation on a submucosal fibroid, the second procedure was on 24/6/14 to remove the fibroid.

These two D & C's have now caused an incompetent cervix, this was never discussed with me as a risk. Consequently I lost my daughter at 18 weeks on 6/1/15 after my membranes reptured during an emergency cerclage procedure. I am now 18 +3 with a preventative cerclage. None of this could have been avoided, I just wish I was better informed.


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