Most Common Complications of D&C

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. The most common complications are:

 1) Pain

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

2) 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

 3) Infection

May occur of uterus and other pelvic organs. Symptoms are abdomen pain, fever and foul smelling discharge from vagina. Management requires a course of antibiotics.

4) 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.

5) 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

6) Adhesions

Scar tissue development 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.

Word of advise from Gynaecologist

– Every procedure has its inherent risks and complications.

– These complications can be minimized by using advanced technology like Hysteroscopy and Ultrasound assisted procedures, use of good antibiotics and use of newer medications for cervical dilatation.