DESCRIPTION

Suction Curettage is a technique of electively terminating a pregnancy. It involves the removal of the fetus and accompanying tissue of the pregnancy from the uterus with instrumental evacuation through the vagina. Over 90 percent of induced abortions in the USA are performed by this method. This information and instruction is based on the assumption that you have had, or will have, counseling and competent guidance in making your decision to seek this procedure for termination of the pregnancy.

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REASONS FOR PROCEDURE

Personal concerns about the social or economic aspects that involve an unplanned pregnancy.

Continuing with the pregnancy may pose a threat to the life of the mother.

Mother has a genetic condition which the fetus is at significant risk of acquiring, or the fetus has been tested and is known to have the condition (such as cystic fibrosis).

Pregnancy resulted from a rape.

Fetus is affected with a major disorder such as chromosomal abnormality or birth defect.

Fear that the fetus has been harmed by medications or other conditions.

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RISK INCREASES WITH

Obesity.

Smoking.

Poor nutrition.

Recent or chronic illness.

Use of drugs such as anti-hypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; narcotics; beta-adrenergic blockers; or cortisone.

Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedative; hypnotics; or cocaine.

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DESCRIPTION OF PROCEDURE

Suction aspiration is a surgical abortion procedure performed during the first 6 to 12 weeks gestation. It is also referred to as suction curettage or vacuum aspiration.

A local anesthetic is used, sometimes accompanied by a tranquilizer. Your abortion provider may give you pain medication and misoprostol in preparation of the procedure.

You will lie on your back with your feet in stirrups and a speculum is inserted to open the vagina. A local anesthetic is administered to your cervix. The opening of the cervix is enlarged by instruments (most often) or other method. Then a tenaculum is used to hold the cervix in place for the cervix to be dilated by cone shaped rods.

When the cervix is wide enough, a cannula, which is a long, small, hollow plastic tube connected to a suction device, is inserted through the vagina and canal of the cervix into the cavity of the uterus to suction out the fetus and placenta. The tube is connected to a suction apparatus.

Gentle suction through the tube removes the uterine contents. You may feel cramps in the lower abdomen, nausea, sweating and faintness.

The tube is removed and the lining of the uterus is scraped with a curette to be sure all the placental tissue is removed.

The procedure usually lasts 10-15 minutes, but recovery may require staying at the clinic for a few hours.

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EXPECTED OUTCOME

Expect complete healing without complication. Allow about 1 week for recovery from surgery.

Future pregnancies should be uncomplicated.

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POSSIBLE COMPLICATIONS

Excessive bleeding.

Perforation or infection of the uterus.

Potential psychological problems.

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SIDE EFFECTS & RISKS

Common side effects that most women will experience following the procedure include cramping, nausea, sweating, and feeling faint.

Less frequent side effects include possible heavy or prolong bleeding, blood clots, damage to the cervix and perforation of the uterus. Infection due to retained products of conception or infection caused by an STD or bacteria being introduced to the uterus can cause fever, pain, abdominal tenderness and possibly scar tissue.

Contact your health care provider immediately if your side effects persist or worsen.

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DILATION & CURETTAGE (D&C)

Dilation and curettage is a surgical procedure performed during the first 12 to 15 weeks gestation when used for an abortion. It is a procedure often used to remove remaining tissue after a spontaneous miscarriage or if there are other uterine conditions in which excessive bleeding is a problem and the contents of the uterus need to be "cleaned out" or the uterine lining needs to be removed to remedy the problem.

Dilation and curettage is similar to suction aspiration with the introduction of a curette. A curette is a long, looped shaped knife that scrapes the lining, placenta and fetus away from the uterus. A cannula may be inserted for a final suctioning. This procedure usually lasts 10 minutes with a possible stay of 5 hours.

SIDE EFFECTS & RISKS OF D&C

The side effects of dilation and curettage are the same as suction aspiration noted above with the exception that there is a slight increased chance for perforation of the uterus.

Contact your health care provider immediately if your symptoms persist or worsen.

REASONS TO USE D&C

Dilation and curettage (D&C) is a procedure in which the cervix of the uterus is expanded (dilated) so that the uterine lining (endometrium) can be removed with a spoon-shaped instrument called a curet or curette. The procedure is performed for a variety of reasons. Most commonly, this surgery is done in order to help determine the cause of abnormal uterine bleeding. It can also be done to help determine the degree of abnormality of the endometrium in cases of cancer or pre-cancerous cells that are detected by an in-office biopsy. D&C is also sometimes necessary to remove tissue after a miscarriage.

In general, a D&C is used to help determine the health of the uterine lining or to remove abnormal tissue. Occasionally, the procedure can correct some of the problems in the uterus such as polyps, scar tissue, or tissue overgrowth.

There are very few contraindications to D&C. Generally if a patient is too ill to undergo surgery, then she should probably not have this procedure. Furthermore, if the patient is unable to move her legs apart, such as with severe arthritis in the hips, the surgeon may not be able to perform the procedure since it requires enough movement of the legs to accommodate a speculum and the surgeon. If the patient is pregnant or thinks that she could be pregnant, she should not have the operation unless the D&C is for the purpose of an abortion.

MoonDragon's ObGyn Procedures: Dilation & Curettage (D&C)



POST-PROCEDURE CARE

GENERAL MEASURES

Have someone drive you home from surgery. Rest quietly there for the remainder of the day.

If you have pain, place a heating pad or hot-water bottle on the abdomen or back. Hot baths frequently promote muscle relaxation and relieve discomfort. Repeat the baths as often as they provide comfort.

Use sanitary napkins for bleeding, which may last for several days. If bleeding continues 10 to 14 days after surgery, you may use tampons.

If contraception is desired, it can often be initiated shortly after the procedure. If you wish to take birth control pills, begin taking them either on the night you return from surgery or the next day. If you prefer an IUD, diaphragm or cervical cap, the fitting can be made during you next clinical appointment.

Your next menstrual period should begin 4 to 6 weeks after the procedure. If you take birth control pills, your first period will begin after you complete the first cycle of pills.

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MEDICATION

Prescription pain medication should generally be required for only 2 to 7 days following the procedure.

You may use non-prescription drugs, such as acetaminophen, for minor pain.

Antibiotics may be prescribed to reduce risk of infection.

Stool softener laxative, if needed to prevent constipation.

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ACTIVITY

Rest quietly at home for the remainder of the day. Resume normal activities slowly the next day, if you feel able. Light or moderate vaginal bleeding will occur on and off for 10 to 14 days after surgery. Bed rest will reduce bleeding.

Avoid sexual relations for 2 weeks following the operation.

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DIET

No special diet.



NOTIFY YOUR MIDWIFE OR HEALTH CARE PRACTITIONER IF...

Any of the following occurs:

Pain, swelling, redness or drainage increases in the surgical area.

You develop signs of infection: headache, muscle aches, dizziness, or a general ill feeling and fever, with a temperature of over 100°F orally.

You experience new symptoms such as nausea, vomiting, constipation or abdominal swelling.

New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

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MoonDragon's ObGyn Womens Health Information: Abortion Index

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