Complications of D & C ( Dilatation & Curettage )

Complications of D & C ( Dilatation & Curettage )

-D & C is a very common gynaecological procedure to manage menstrual problems, to offer surgical abortion ( MTP- Medical termination of pregnancy ) & as a part of infertility work up -Every procedure has its inherent risks and complications-These complications can be minimized by using advanced technology like Hysteroscopy and Ultrasonud assisted procedures, use of good antibiotics and use of newer medications for cervical dilatation.
Complications

Pain
– Lower abdominal, menstrual like cramping is expected for a couple of days after procedure
– Normal pain killers are adequate to manage

Bleeding
-Vaginal bleeding to some extent is expected.
-If quantity is more or duration is prolonged it is abnormal
-Management requires ultrasound for diagnosis & repeat D & C

Infection
– May occur of uterus and other pelvic organs
-It presents as pain abdomen , fever and foul smelling discharge from vagina
-Management require course of antibiotics

 Injury to cervix
-Access to uterine cavity for the purpose of procedure is gained by dilatation of cervix ( mouth of uterus)
-This at times may lead to laceration (tearing ) and bleeding
– Management requires taking stitches on cervixs

Perforation
-It can occur with any instrument that is put inside uterus.
– Uterus, Bowel (Intestines and rectum), Urinary bladder, Blood Vessels are most commonly injured organs.
-There are more chances of injury if there has been a previous operation like Caesarean delivery, myomectomy ( operation for removal of fibroids) etc.
-Management depends on the organ involved, extent of injury and general condition of patient.
– Laparoscopy – (Key hole surgery) can be performed to diagnose the site of perforation as well as repair of damaged organ.
-Laparatomy – ( Open abdominal surgery ) is required in cases where extent of damage is more.
-Blood transfusion, Intervention by general surgeon , ICU care – all of them are rare but known clinical situations

 Adhesions
-Scar tissue developing inside uterus-known as Asherman’s syndrome
-Repeated D& C procedures may lead to this condition.
-The anterior and posterior walls of the uterus get stuck to each other.
-It will result in scanty or no menstruation subsequently
-Management requires- Hysteroscopy ( Looking inside cavity of uterus through instruments) and cutting of fibrous tissue.
– Further pregnancies may be complicated by miscarriage or ectopic pregnancy ( Pregnancy occurring at sites other than uterus) etc.

Anaesthesia complications 
Allergic reactions to medications