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Risks

With any medical procedure, there are risks, and these should be weighed and compared against the risks and benefits of the other treatment options as you discuss them with your doctor.

1.      Anesthesia – there are risks associated with general, spinal or local anesthesia.

2.      Uterine perforation/puncture – can lead to uterine rupture in future pregnancies and can expose the bladder and/or intestines to injury. 

3.      Hemorrhage (greater than 500 cc of blood loss)– immediate or delayed and is potentially life threatening; note that a suction D&C can also stop, at least temporarily, hemorrhage.

4.      Infection – can require hospitalization and can be life threatening. 

5.      Asherman’s Syndrome – Intrauterine adhesions or scarring of the uterus, which can cause decreased or absent periods, cyclical cramping/pain, recurrent miscarriages and infertility, and can result in endometriosis or hematometra (a collection of blood trapped within the uterus)  Go to www.ashermans.org for more information. 

6.      Blocked Tubal Openings – caused by scarring, infection or a combination, and can result in infertility or ectopic pregnancies.

7.      Retained products of conception –because this is a blind procedure, it can result in a repeated D&C and/or infection, however, a post D&C ultrasound reduces this risk further.

8.      Cervical damage – tears or damage to the cervix and internal os (entrance to the uterus) can result from the dilation process which can affect future pregnancies. There is a correlation between the degree of dilation and birth weight. According to Slater, the greater the dilation, the lower the birth weight (18). This risk may be decreased by the use of misoprostol or laminaria.

9.      Cervical Insufficiency (CI) – forced dilations, repeated dilations or dilation greater than one centimeter can result in CI, or the cervix dilating prematurely during future pregnancies and thus resulting in pre-term deliveries.