D&C Following a Miscarriage: What You Need to Know About This Procedure

I had a miscarriage and was just told I need a D&C. Could you explain the procedure?


Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

A D&C (dilatation and curettage) is sometimes performed to "complete" a miscarriage. Remaining fragments of decidual or endometrial lining are removed. If there is still embryonic or placental tissue left behind, this procedure will remove them.

First, a speculum is placed in the vagina and anesthesia is assured with a paracervical block (a numbing agent is instilled into several quadrants around the cervix). Often the mother is given a sedative medication as well. If the D&C is completed in a hospital in the operating room, a general anesthetic may be given.

The cervix and uterus are stabilized with a tenaculum, which is like a two pronged pincher sort of clamp. This is used to apply traction to straighten out the natural bend in the cervical-uterine junction.

The uterus is "sounded" (the depth is measured), by passing a long probe until it comes in contact with the fundus or top of the uterus. Then dilators or progressively larger instruments are passed through the cervix to open it.

A curette is passed in and out of the cervix and gently comes into contact with the walls of the uterus until all tissue is extracted. As an adjunct to this, some physicians will use a suction device also.

After the procedure, the physician examines the tissue and sends it to pathology for evaluation. The client is awakened or allowed to sit up and rest at this point. Bleeding is like a period and subsides rapidly over the period of a few hours to a few days. Intercourse or tampons are not recommended for 7 to 14 days. Sometimes, antibiotics are prescribed for 3 to 7 days.

Unless, the procedure resulted in infection or some complication such as perforation, there should be no scarring that would affect your fertility.

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