Recognizing curettage, a medical procedure performed after a miscarriage

Curette or also known as curettage is a term that may be familiar to the ears of women. Curette is closely related to miscarriage. After a pregnant woman has a miscarriage, the mother will be curetted to clean the uterus. To find out more about curette (curettage), you should consider the following explanation.

What is curettage (curettage)?

Curette in medical language is usually known as D&C (dilation and curettage) or in Indonesian it is called dilation and curettage. According to Johns Hopkins Medicine, curettage or curettage cannot be separated from previous dilation procedures.

Dilation and curettage are surgical procedures that are often performed after a woman has a miscarriage in the first trimester of pregnancy.

Dilation refers to the widening or opening of the cervix because the cervix of the mother certainly does not open on its own after a miscarriage. During childbirth, the mother's body automatically stimulates the opening of the cervix (cervix) which is also assisted by the push of the baby's head.

Meanwhile, during a miscarriage, the mother's body does not stimulate the opening of the cervix so it needs to be dilated to open the cervix. After dilation, the next step is curettage.

Curettage refers to the procedure of removing and cleaning the uterine contents from abnormal tissue. Meanwhile, curette, which you may hear more commonly, is actually a spoon-like surgical instrument used to perform curettage.

When does curettage (curettage) need to be done?

It turns out that not only after a miscarriage, dilation and curettage with curettage also need to be done at the following times:

Abortion or after childbirth

Dilation and curettage with curettage are necessary to remove tissue in the uterus during or after a miscarriage or abortion.

Meanwhile, after delivery, dilation and curettage (curettage) need to be done to remove the remains from the placenta. This cleaning is done to prevent infection or heavy bleeding after childbirth.

Diagnosing or treating uterine abnormalities

Dilation and curettage (curettage) can help diagnose or treat tissue abnormalities in the uterus. Examples of abnormalities in the uterus include fibroids, polyps, endometriosis, hormonal imbalances, or uterine cancer.

The sample of uterine tissue that has been successfully taken will be further examined in the laboratory for possible abnormalities of the uterine cells.

How does the curettage process take place?

As explained above, the first procedure performed is dilation and then curettage. All of these procedures usually take 15-30 minutes.

The following are the steps that are usually taken during the curettage process:

Dilation

Launching from the American Pregnancy Association, doctors usually give antibiotics intravenously and in the mouth (orally) to help prevent infection. The doctor will then check the cervix whether it is open or closed.

If the cervix is closed, the doctor will insert a device called a dilator to open the cervix so that a curette device can later be inserted into the cervix.

The doctor will open your vagina and then slowly dilate your cervix so that the doctor can reach your uterus.

In addition, the doctor can also give you drugs to soften the cervix so that it is easier for it to be dilated.

If necessary, a speculum device can be used to keep the cervix open. So that you don't feel in pain, your doctor will likely give you a medicine that makes you numb.

Curettage

After the dilation process is complete, the doctor will reach your uterus. At this time, the doctor will use a curette tool to perform a curettage.

The curette device is known as a vacuum aspiration (suction curretage). The device is equipped with a flexible tube to clean the contents of the uterus. The length of the tube on the curette kit can be adjusted according to the number of weeks of pregnancy when you had a miscarriage.

For example, a 7 millimeter (mm) flexible tube will be used to clean the contents of the uterus at 7 weeks of gestation. The doctor will slowly rub this tool into the lining of your uterus so that any abnormal tissue in your uterus can be cleaned.

Next, the doctor will see if the uterus is hard and is accompanied by cessation of bleeding or at least much less.

If the uterus is hard and the bleeding has reduced, the speculum that was previously used as an aid to open the cervix will then be pulled back. This is a sign that your curettage process has been completed.

What will happen to the mother after the curette?

Just like after giving birth, you will also feel a little pain after undergoing the dilation and curettage procedure.

You will feel cramps and experience minor bleeding such as spotting. This is a normal condition for you to feel so there is no need to worry.

The recovery process after dilation and curettage depends on the type of procedure performed and the type of anesthesia (anesthesia) given. Therefore, you can recover in just a few hours or it could take more than a day.

After curettage, it is better for you not to have sexual relations with your partner. Advice not to have sex after curettage should be done for at least 2 weeks or at least until your bleeding has stopped.

In addition, you should limit your activities, such as not doing strenuous activities or lifting heavy weights. The menstrual period after your curettage may occur earlier or later than usual.

This is because the lining of your uterus has been eroded and is taking time to rebuild.

Are there any risks or complications after curettage?

In very rare cases, sometimes scar tissue will form inside the uterus or around the cervix after undergoing a curette. This is known as Asherman's syndrome which can cause infertility and changes in the menstrual cycle.

To cure this syndrome, you can perform another operation to remove the scar tissue. Most likely this condition can be resolved and you will recover.

If you miscarry over 20 weeks of pregnancy, there is a risk of scarring or developing other complications.

Examples of complications that may arise at this gestational age include heavy bleeding, infection, and perforation or the formation of a hole in the uterine wall. This happens because the uterus expands bigger and thinner during pregnancy.

Complications after curettage may be rare. However, you should check with your doctor immediately if you experience any of the following:

Heavy and prolonged bleeding or blood clots
Fever
Abdominal pain
Foul-smelling vaginal discharge

Can a curette affect the chance of getting pregnant again?

The short answer is, not at all. Having curettage (curettage) after a miscarriage will not reduce your chances of getting pregnant again.

In fact, your chances of getting pregnant again after having a miscarriage and having a curettage will be the same as if you had never had a miscarriage.

Based on research American College of Obstetrics and GynecologyAbout 65% of women who have had 4 miscarriages in a row succeed in getting pregnant again until they have a baby.

Experts recommend waiting up to three menstrual cycles after curettage before you try to get pregnant again.

This aims to give the uterus time to rebuild its lining. This is so that the uterus is healthy again when you get pregnant again.