MISCARRIAGE- WHAT IS A D&C?

A miscarriage generally refers to a failed pregnancy.  This condition is associated with risk of bleeding and infection.  There are three treatment options for miscarriage namely, await spontaneous expulsion; expedite the process with medication or a surgical removal of the product of conceptus (D&C).

A dilatation and curettage (D&C) is a general term that refers to a surgical procedure to remove pregnancy tissue from within the uterus when a miscarriage has not completed. The procedure involves the dilatation of the cervix (neck of the womb), followed by removal of pregnancy tissue via suction or blunt curetting. When a difficult cervical dilatation is anticipated, tablets or pessaries may be given to soften the cervix and make the operation safer.  This procedure is takes about 15-30 minutes and usually done under a short general anaesthesia.  The patient will be observed at the Daycare ward for the next 6-8 hours before is allowed home.

 

The important risks associated with this procedure includes

  • Cervical tear (rare)
  • Uterine perforation (uncommon; 5 in 1000 women)
  • Heavy uterine bleeding (uncommon ; 1-2 in 1000 women)
  • Need for repeat procedure (common; 5 in 1000 women)
  • Localized pelvic infection (common; 3 in 100 women)

The intended benefits of this procedure are to remove the pregnancy tissue, prevent excessive unexpected bleeding and infection arising form the failed pregnancy.  This occurs in cases of incomplete or missed miscarriage, or retained placenta tissue, when the patient prefers surgical methods over others form of evacuation.  It also allow patient to “move on and resume her life” as soon as possible.

 

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Author: Dr Ng Soon Pheng

Dr. Ng Soon Pheng MD(USM), M.Med (O&G), Fellow Reprod Medicine (Singapore), AM (Mal) Dr. Ng Soon Pheng qualified from University Kebangsaan Malaysia (UKM), Malaysia. After obtaining his post graduate degree, Dr. Ng Soon Pheng continued his clinical fellowship training in the field of IVF in Singapore. He was also the recipient of Yayasan Sultan Iskandar (Johor) Scholarship for the fellowship stint. Dr. Ng Soon Pheng has more than 10 years of working experience in the field of Obstetrics and Gynaecology in the public and university hospital, with special interests in infertility. He was an Associate Professor with the Department of O&G in Universiti Kebangsaan Malaysia (UKM) specialising in infertility. Dr. Ng Soon Pheng is currently Consultant Obstetrician and Gynaecologist with special interests in infertility at Columbia Asia Hospital - Puchong.