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Background Abortion type First use Surgical Late 19th century 4-12 weeks
Gestation
Usage WHO recommends only when manual vacuum aspiration is unavailable United States 1.7% (2003)
Medical notes
Undertaken under heavy sedation or general anesthesia. Risk of perforation. Day-case procedure
Infobox references
Dilation (or dilatation) and curettage (D&C) refers to the dilation (widening/opening) of the cervix and surgical removal of part of the lining of the uterusand/or contents of the uterus by scraping and scooping
(curettage). It is a therapeutic gynecological procedure as well as a rarely used method of first trimester abortion.[1][2] D&C normally refers to a procedure involving a curette, also called sharp curettage.[1] However, some sources use the term D&C to refer more generally to any procedure that involves the processes of dilation and removal of uterine contents, which includes the more common suction curettage procedures of manual and electric vacuum aspiration.[3]
Contents
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Procedure [edit]
Complications [edit]
Complications may arise from either the introduction or spreading of infection, adverse reaction to general anesthesia required during the surgery or from instrumentation itself, if the procedure is performed blindly (without the use of any imaging technique such as ultrasound or hysteroscopy). One risk of sharp curettage is uterine perforation. Although normally no treatment is required for uterine perforation, a laparoscopy may be done to verify that bleeding has stopped on its own. Infection of the uterus or fallopian tubes is also a possible complication, especially if the woman has an untreated sexually transmitted infection.[1] Another risk is intrauterine adhesions, or Asherman's syndrome. One study found that in women who had one or two sharp curettage procedures for miscarriage, 14-16% developed some adhesions.[9] Women who
underwent three sharp curettage procedures for miscarriage had a 32% risk of developing adhesions.[9] The risk of Asherman's syndrome was found to be 30.9% in women who had D&C following a missed miscarriage,[10] and 25% in those who had a D&C 14 weeks postpartum.[11][12][13] Untreated Asherman's syndrome, especially if severe, also increases the risk of complications in future pregnancies, such as ectopic pregnancy, miscarriage, and abnormal placentation (e.g.placenta previa and placenta accreta).[1] According to recent case reports, use of vacuum aspiration can also lead to intrauterine adhesions.[14]