A Dilation and Curettage (D&C) is a gynecological procedure to remove tissue from the uterus. It involves gently widening the cervix, then using a curette to scrape or suction tissue from the uterine lining. D&Cs are performed for various reasons, including diagnosing abnormal bleeding, treating heavy periods, or clearing the uterus after a miscarriage or abortion. Some bleeding is common and expected as the uterus heals, and understanding the typical recovery process can address concerns about its duration.
Normal Bleeding After D&C
Light vaginal bleeding or spotting is common after a D&C, lasting from a few days to several weeks. Initially, it may resemble a light menstrual period with a bright red color. As the uterus heals, the discharge typically changes to a brownish or pinkish hue, indicating older blood.
The discharge is generally light, often spotting rather than a heavy flow. Mild cramping, similar to menstrual cramps, and passing small blood clots are also common during the initial days. While bleeding often subsides within one to two weeks, light bleeding or spotting can be normal even at three weeks post-procedure as the uterine lining sheds and regenerates.
Signs Requiring Medical Attention
While some bleeding after a D&C is normal, certain signs require immediate medical evaluation. Heavy bleeding, defined as soaking more than two sanitary pads per hour for several consecutive hours, is a serious concern. The passage of large blood clots, especially those larger than a 50-cent piece, also warrants prompt medical attention.
Severe abdominal pain or cramping that progressively worsens, or pain not relieved by over-the-counter medication, can signal a complication. A fever of 100.4°F (38°C) or higher, accompanied by chills, suggests a potential infection. Foul-smelling vaginal discharge indicates a possible uterine infection, such as endometritis. These symptoms may point to issues like retained products of conception or a developing infection.
Reasons for Persistent Bleeding
Persistent bleeding extending for three weeks or more after a D&C can stem from several factors, from normal recovery to complications. Physiologically, the uterus needs time to heal and regenerate its lining. This natural shedding and regrowth can result in prolonged light bleeding or spotting as uterine tissue stabilizes. Hormonal fluctuations are also common as the body adjusts, influencing bleeding duration and pattern.
Persistent bleeding may also indicate retained products of conception (RPOC), where tissue was not completely removed. This can prevent proper uterine contraction, leading to continued bleeding and infection risk. A uterine infection, such as endometritis, can also cause inflammation and prolonged bleeding. Less common reasons include an underlying clotting issue or, rarely, a uterine perforation during the procedure.
Tips for Post-D&C Recovery
Supporting recovery after a D&C involves several practical steps to facilitate healing and minimize complications. Adequate rest is important during the initial days, and strenuous activities should be avoided. Most individuals can resume normal daily activities within one to two days, but heavy lifting or intense exercise should be postponed.
To prevent infection and support healing, refrain from sexual intercourse and avoid using tampons for one to two weeks, or as advised by a healthcare provider. Good hygiene, such as daily showering, is encouraged. Maintain open communication with healthcare providers and attend all scheduled follow-up appointments. If concerns arise regarding the nature or duration of bleeding, seek professional medical advice.