Genel
Dilation and Curettage (Abortion): Comprehensive Pregnancy Termination Guide
Understanding Curettage: Medical and Diagnostic Applications
Dilation and curettage (D&C) is a precise gynecological procedure utilizing specialized instruments to remove uterine contents. This versatile technique serves multiple purposes:
Therapeutic Uses:
✔ Complete pregnancy termination (first and second trimester)
✔ Treatment of endometrial hyperplasia
✔ Removal of uterine polyps and fibroids
✔ Management of incomplete miscarriage
✔ Postpartum hemorrhage control
Diagnostic Applications:
- Endometrial biopsy for cancer screening
- Evaluation of abnormal uterine bleeding
- Investigation of infertility causes
- Diagnosis of chronic endometritis
Indications for Pregnancy Termination
Elective Termination Reasons:
- Contraceptive failure (condom breakage, pill failure)
- Socioeconomic factors (financial instability, unstable relationships)
- Educational/career planning
- Personal choice and reproductive rights
Medical Necessity Cases:
⚠ Missed abortion (embryonic demise)
⚠ Anembryonic pregnancy (blighted ovum)
⚠ Ectopic pregnancy (non-uterine implantation)
⚠ Severe fetal abnormalities (incompatible with life)
⚠ Maternal health risks (cardiac disease, cancer treatment)
Gestational Limits:
✅ Weeks 1-10: Available on patient request
✅ Weeks 10-20: Requires medical justification
✅ Beyond 20 weeks: Only for life-threatening conditions
Required Documentation:
- Pre-procedure counseling certificate
- Ultrasound confirmation of gestation
- Medical board approval (for late-term cases)
Termination Methods: Comparative Analysis
1. Medical Abortion (Pill Method)
- Drug Protocol: Mifepristone + Misoprostol combination
- Effectiveness: 95-98% for early pregnancies
- Process:
- Clinic-administered first dose
- Home completion within 24-48 hours
- Follow-up ultrasound verification
- Advantages:
- Non-invasive
- Private experience
- No anesthesia required
2. Vacuum Aspiration (MVA/EVA)
- Procedure Time: 5-15 minutes
- Anesthesia: Local or mild sedation
- Technology:
- Electric vacuum aspirator (EVA)
- Manual vacuum aspiration (MVA)
- Recovery:
- 1-2 days light bleeding
- Normal activities resume in 24 hours
3. Surgical Curettage (D&C)
- Indications:
- Second trimester termination
- Incomplete medical abortion
- Molar pregnancy
- Advanced Techniques:
- Ultrasound-guided evacuation
- Hysteroscopic assistance
- Cell-saving autotransfusion systems
- Safety Protocols:
- Pre-op antibiotics
- Sterile field maintenance
- Real-time vitals monitoring
Pre-Procedure Preparation
Medical Evaluation:
- Complete blood count (CBC)
- Blood type and Rh factor
- STI screening (HIV, hepatitis, syphilis)
- Transvaginal ultrasound
Patient Instructions:
- 6-hour fasting (if using sedation)
- Companion requirement for transportation
- Discontinue blood thinners 3 days prior
Post-Procedure Care Protocol
Immediate Aftercare (First 24 Hours):
- Monitoring for hemorrhage (soaking >2 pads/hour)
- Pain management (NSAIDs recommended)
- Anti-D immunoglobulin for Rh-negative patients
Week 1 Recovery:
✔ Pelvic rest (no intercourse/tampons)
✔ Temperature monitoring (fever check)
✔ Light activity only
Long-Term Follow-Up:
- 2-week post-op visit
- Contraception initiation (IUD, implants, pills)
- Psychological counseling availability
Potential Complications and Management
Risks (1-2% Incidence):
- Incomplete evacuation (requires reaspiration)
- Uterine perforation (laparoscopic repair if needed)
- Asherman’s syndrome (adhesion prevention)
- Post-abortion infection (antibiotic therapy)
Warning Signs Requiring Medical Attention:
⚠ Severe abdominal pain unrelieved by medication
⚠ Heavy bleeding with clots (larger than golf ball)
⚠ Foul-smelling discharge
⚠ Persistent fever >38°C
Contraceptive Options Post-Procedure
Immediate Initiation Methods:
- Copper IUD (insertable same-day)
- Progestin-only pills (no estrogen risk)
- Contraceptive implant (3-5 year protection)
Future Planning:
- Fertility awareness education
- Permanent sterilization options
- Emergency contraception access
Book your appointment online at en.yuliyadoster.com/online-appointment or contact us by phone at +90 544 885 01 00.
We look forward to assisting you!
