1. What is surgical abortion?


    Surgical abortion (Dilation and Curettage also known as D&C) is a commonly used method to terminate the first trimester of pregnancy. It is suitable for those who are less than 10 weeks pregnant. The procedure involves the extraction of pregnancy tissue (such as villi, sacs, etc.) from the uterus by surgical measure to terminate the pregnancy.


    In order to facilitate the suction device and other instruments into the uterine cavity, the need to use a cervical dilator to gradually expand the cervix, plus the negative pressure suction process and the final curettage process, these will bring discomfort to you, even pain. During the operation, the patient’s relaxed mood and active cooperation with the surgeon can reduce discomfort to a certain extent. Many hospitals now have the option of performing a D&C under anesthetic analgesia, which can reduce discomfort but also increase the additional risk of anesthesia.


    2. What is the effect of D&C on the body?


    All operations have the potential for complications. Although the procedure is generally safe, it can lead to uterine damage in special circumstances, such as many time miscarriages, only a few months after the last delivery (or miscarriage), or excessive uterine forward flexion.


    Artificial abortion too soon and too many, will cause greater damage to the endometrium, adverse impact on the future pregnancy. Therefore, unwanted pregnancies should be avoided as much as possible, and when they do occur, early termination is less damaging.


    3. What should be paid attention to before the D&C?


    Preoperative medical history should be truthfully provided, and necessary preoperative examinations should be completed to determine whether surgery can be performed and whether there are any high-risk factors (such as the presence of genital tract infection, lactation, etc.). You can ask your doctor about the operation and sign the informed consent form after you are fully informed.


    The day before the operation should do a good personal hygiene, better take a bath, change clothes, wash perineum area. Do not have intercourse, pay attention to rest, appropriate nutritional diet.


    If the patient is selected to receive D&C under anesthesia, on the date of surgery: before the operation, solid food (including milk and granular drinks) should be avoided for 6 hours, water should be forbidden for 2 hours, and empty your bladder.


    4. Consider the contraceptive measures implementing after the operation to avoid another accidental pregnancy


    Make full use of the time before the operation to communicate with the doctor, understand the various contraceptive options available after the operation and how to use them effectively;


    • IUD can be placed at the same time of operation.

    • or start taking short-acting oral contraceptives immediately after surgery;

    • or use a condom when having sex again


    Post-Surgical Abortion education


    Will I have symptoms after a surgical abortion?


    • Pain and cramping in the lower belly. This lasts for a few hours.

    • Bleeding from the vagina. This is usually lighter than after a medication abortion. The bleeding can last for up to 2 weeks.


    Should I call my doctor or nurse after an abortion?


    Call right away if:

    • Your bleeding is heavy enough to soak through 1 menstrual pad each hour, for at least 2 hours, and you are still bleeding

    • Your pain is really bad (it makes you double over or makes it hard to move), and you don’t feel better with pain medicines, such as ibuprofen (sample brand names: Motrin, Advil)

    • You have a fever higher than 100.4°F (38°C)

    • Bad-smelling discharge comes out of your vagina


    Incomplete abortion


    In some cases, abortion does not work completely. In other words, they do not always get rid of all the pregnancy tissue. If that happens to you, you will need to take additional medicine or have a procedure to remove any leftover tissue. Signs that an abortion was not complete include:


    • Not bleeding after a medication abortion

    • Still having pregnancy symptoms, such as nausea and tender breasts, 1 week or more after your abortion

    • Bleeding for more than 2 weeks after an abortion

    • Not having a period in the first 6 weeks after an abortion


    Is there anything I should do differently after an abortion?


    Do not have sex or put anything into your vagina for 2 weeks after an abortion. If you do, you could get a very serious infection.


    What if I want to get pregnant again someday?


    Having an abortion does not make it harder to get pregnant again. Abortions do not harm your health, and they do not harm the health of your future babies.


    Reference:
    Shanghai maternal and child health center
    UpToDate

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    2021-06-01