A spontaneous abortion, also known as a miscarriage, is the term used when a pregnancy ends on its own within the first 20 weeks. Approximately 10 to 25 percent of pregnancies end in miscarriage, according to the American Pregnancy Association. Following a miscarriage, a woman may have a surgical procedure known as a dilation and curettage, or D&C, to remove any remaining fetal tissue within the uterus. Like most surgical procedures, there is a risk of complications.
Procedure
A dilation and curettage is commonly performed in a outpatient center or hospital, and the patient may be under general anesthesia, where she is completely sedated, or local anesthesia, where she is awake for the procedure. The physician may have to dilate the cervix prior to the procedure, and he will either insert a luminaria, a rod that absorbs moisture causing the cervix to dilate, or give medication to soften the cervix. During the procedure, the physician will insert a device to hold the vagina open and a clamp to hold the cervix in place. The physician will then slowly open the cervix and remove any remaining tissue within the uterus with a suctioning instrument known as a curette.
Types
The American Congress of Obstetricians and Gynecologists warns that complications of a D&C can include bleeding, infection or perforation of the uterus. Physicians are not able to see inside the uterus as they work, and it is possible to pass the tip of an instrument through the uterus, causing bleeding and damage to surrounding organs. If tissue remains in the uterus following the procedure, it is possible for the tissue to die and cause a severe systemic infection. Scar tissue may build within the uterus following the procedure, a disorder known as Asherman's syndrome, according to MayoClinic.com.
Identification
It is common for patients to experience bleeding after a dilation and curettage procedure. Patients can expect mild cramping for many days and light bleeding for a bit more than a week. Patients under general anesthesia may experience side effects such as mild nausea and vomiting and a sore throat from having a breathing tube inserted into the windpipe during surgery, according to the American Congress of Obstetricians and Gynecologists. However, heavy bleeding from the vagina, fever, severe abdominal pain and foul smelling discharge from the vagina can indicate a severe infection or complication and patients should contact their physician.
Time Frame
Patients will often notice symptoms of a systemic infection within the first few days following the procedure. However, because the cervix can remain open for days following surgery, it is possible for bacteria to enter the vagina, causing an infection. In the case of a complication such as Asherman's syndrome, it may take years for a patient to realize they have this complication, according to American Congress of Obstetricians and Gynecologists.
Considerations
Complications are rare and recovery usually takes only a few days. To avoid infections, patients should follow all post-surgical procedure instructions and avoid inserting anything into the vagina until the follow up appointment with their physician.
