Uterus: A muscular organ in the female pelvis. During pregnancy, this organ retains and nourishes the fetus. Uterus (also called uterus). The uterus is a hollow, pear-shaped organ located in a woman`s lower abdomen, between the bladder and rectum. The uterus loses its lining every month during menstruation, unless a fertilized egg (egg) is implanted and pregnancy follows. In the treatment of spontaneous or induced abortions, the preparation (softening and dilation) of the cervix allows vacuum aspiration to enter the uterus more easily, which can make the procedure shorter, more comfortable and easier for the patient to perform. [7] [8] The preparation may also reduce the rare complications of uterine perforation and cervical lesions. [7] [9] Options for cervical preparation prior to the abortion procedure include osmotic dilators and pharmacological agents. Osmotic dilators produce large cervical dilation predictably and are typically used in more advanced pregnancies. [7] [9] Pharmacological agents such as misoprostol and mifepristone soften the cervix and facilitate dilation of the cervix and can be used alone in early pregnancy or in combination with osmotic dilators prior to dilation and evacuation. [7] [9] As there are now non-invasive medical abortion methods, dilation and curettage have decreased as abortion methods, although sucking curettage is still the most common method of terminating pregnancy in the first trimester.
[7] [8] The World Health Organization recommends D&C with a sharp curette as a surgical abortion method only when manual vacuum aspiration with a suction curette is not available. [9] During pregnancy, the bone (opening) of the cervix is blocked by a thick mucus plug to prevent bacteria from entering the uterus. During dilation, this plug is released. It can come out of the vagina as a lump or as a discharge of thick mucus. When this happens, it is an indication that the cervix is beginning to dilate, although not all women notice that this mucous plug is released. A D&C can also be used to remove pregnancy tissue during an abortion during the first trimester or during a miscarriage. About half of women who miscarry do not need a D&C procedure. If the miscarriage occurred before the 10th. If the week of pregnancy occurs, it will probably pass on its own and will not cause any problems. After the 10th week of pregnancy, the risk of incomplete miscarriage is higher. In this case, you may need a D&C procedure to make sure your uterus is clean. Miscarriage: Loss of a pregnancy that is in the womb.
A D&C can be done early in pregnancy to remove pregnancy tissue, either in the case of a non-viable pregnancy, such as a missed or incomplete miscarriage, or an unwanted pregnancy, such as a surgical abortion. [6] Medical treatment of miscarriages and medical abortions with drugs such as misoprostol and mifepristone are safe, non-invasive and potentially less expensive alternatives to D&C. In the later stages of pregnancy, the cervix may already have opened up to 1-3 cm (or more in rarer circumstances), but during labor, repeated uterine contractions lead to further enlargement of the cervix to about 6 centimeters. From this point, the pressure of the presenting part (head in parietal births or buttocks in breech births), as well as uterine contractions, will enlarge the cervix to 10 centimeters, which is “complete”. Cervical dilation is accompanied by effacement, thinning of the cervix. Another risk is intrauterine adhesions or Asherman`s syndrome. One study found that among women who had one or two acute curettages due to miscarriage, 14-16% developed adhesions. [18] Women who underwent three acute curettage procedures for miscarriage had a 32% risk of developing adhesions. [18] The risk of Asherman syndrome was 30.9% in women who had D&C after a missed miscarriage[19] and 25% in those who had D&C 1-4 weeks after delivery.
[20] [21] [22] Untreated Asherman syndrome, especially when severe, also increases the risk of complications in future pregnancies, such as ectopic pregnancy, miscarriages, and abnormal placentation (such as placenta previa and placenta accreta). According to recent case reports, the use of vacuum aspiration can also lead to intrauterine adhesions. [23] A 2013 systematic review concluded that recurrent miscarriage and D&C are the main risk factors for intrauterine adhesions. [24] However, this review also found no studies reporting an association between intrauterine adhesions and long-term reproductive outcomes, and that similar pregnancy outcomes have been reported after surgical treatment (including D&C), medical treatment, or conservative management (i.e. watchful waiting). [24] Heavy bleeding from the vagina (soaking up to two towels per hour for 2 hours straight) You may experience cramps similar to menstrual cramps. Over-the-counter pain relievers can relieve cramps. A suction D&C uses suction to remove uterine contents.
A D&C suction can be used after a miscarriage to remove the fetus and other tissues if they have not all been passed naturally. Infection or heavy bleeding can occur if these tissues are not completely removed. The cervix is dilated by inserting a series of thin rods. Each rod has a larger diameter than the previous one. This process gradually enlarges the opening of the cervix so that the curette (spoon-shaped instrument) can be inserted. Compiled from information from the following sources: Cervix. The lower and narrow part of the uterus is located between the bladder and rectum, forming a canal that opens into the vagina and leads outside the body. In addition to having a complete medical history, your doctor may perform a complete physical exam to make sure you are healthy before the procedure. You may have blood tests or other diagnostic tests. Last reviewed by a doctor at the Cleveland Clinic on 15.03.2021.
You can resume your normal diet unless your doctor advises you otherwise. You can have a D&C at your doctor`s office, an outpatient clinic, or at the hospital. It usually only takes 10 to 15 minutes, but you can stay in the office, clinic, or hospital for up to five hours. Your doctor will need your complete medical history and a signed consent form. Tell the doctor if: Cleveland Clinic is a nonprofit academic medical center. Advertising on our website helps support our mission. We do not endorse products or services that are not provided by the Cleveland Clinic. Guidelines Your cervix can be cleaned with an antiseptic solution.
You may be asked not to shower, use tampons, or have sex for two to three days after a D&C or for a period recommended by your doctor. You may also have other limitations on your activity, including no strenuous activity or lifting heavy objects. The recovery process depends on the type of procedure performed and the type of anesthesia administered. A D&C or dilation and curettage is a procedure to remove tissue from your uterus. Your doctor may use a D&C and hysteroscopy to diagnose unexplained bleeding. So it can help your provider find the answers you`ve been looking for for a long time.