Evacuation of Uterus: Procedure and Information

What is the evacuation of the uterus?

The evacuation of the uterus, also known as dilatation and evacuation (D&E) or dilatation and curettage (D&C), is a minimally invasive surgical procedure. 

D&E involves dilating the cervix and removing fetal tissue typically after the first trimester, while D&C involves dilating the cervix and scraping the uterine lining, often for diagnostics or post-miscarriage. The tissue is extracted using instruments, which may involve gentle suction or scraping of the uterine lining with a curette. 

The indications for surgical uterine evacuation include: 

1. Miscarriage (Death of the embryo or fetus)

2. Incomplete medical abortion (Using pills)

3. Termination of pregnancy

Post-uterine evacuation

After a uterine evacuation, it is important to follow these guidelines to ensure proper recovery and reduce the risk of complications: 

• Rest when you feel tired.

• Ensure you get adequate sleep.

• Use sanitary pads instead of tampons.

• Stay hydrated by drinking plenty of fluids.

• Maintain a normal diet; if your stomach is upset, opt for bland, low-fat foods such as plain rice, broiled chicken, toast, and yoghurt.

• Take painkillers as prescribed.

• Contact your doctor if you develop a fever, foul-smelling discharge, or severe pain.

When should I be worried after a uterine evacuation procedure?

After completing the surgery, you should alert your healthcare provider if you experience any of the following:

1. Fever

• The development of a fever after the procedure may indicate an infection.

2. Abnormal, heavy, or unexplained bleeding

• If you require more than one pad per hour, seek medical attention immediately to prevent excessive blood loss.

3. Severe abdominal pain

• If the pain is not relieved by painkillers, consult your doctorFoul-smelling vaginal discharge: This may indicate an infection and should be addressed promptly by a healthcare professional.

What are the complications of a uterine evacuation?

The following are potential complications that may arise from a uterine evacuation procedure:

1. Infection

2. Bleeding or haemorrhage

3. Cervical or vaginal laceration

4. Uterine or bowel perforation

5. Incomplete or failed abortion

6. Anesthesia-related complications

7. Intrauterine adhesions (Asherman syndrome)

8. Cervical incompetence (Rare)

9. Maternal death (Very rare)

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a gynaecologist at Thomson Women's Clinics.

FAQ

How long does an evacuation of the uterus take?

This procedure should take about 10-20 minutes.

How can I determine if my uterus has been completely evacuated?

You may experience bleeding following the evacuation of the uterus, which should subside within two weeks. It is recommended that you undergo a scan by your doctor after the procedure to ensure that your uterus is completely empty.

Will it be painful during an evacuation of the uterus?

You will probably be sedated or under anaesthesia during the evacuation of the uterus, thus you should not feel pain during the procedure. However, you might feel some discomfort or pain after that.

How will I feel after an evacuation of the uterus?

During the first few days after the evacuation of the uterus, you might experience mild cramping, spotting and light bleeding. 

How long will I bleed after an evacuation of the uterus?

You might experience bleeding for a few days up to 2 weeks. The bleeding should become lighter after the first few days. You may pass some tissue or blood clots or have light bleeding for longer than two weeks.

How long does it heal after an evacuation of the uterus?

The recovery period usually lasts around 1-2 weeks. However, some women might need a longer time to recover fully. 

What should be avoided after a uterine evacuation?

• Avoid consuming alcohol and smoking. Refrain from strenuous exercise, such as swimming, for the first two weeks. Additionally, do not insert anything into the vagina, including tampons, douching, or engaging in sexual intercourse, during this period. 

• This precaution is necessary because the dilation of the cervix during the procedure makes the uterus more susceptible to infection.

How long should I rest after the evacuation of the uterus?

You are advised to take some rest for 1-2 days, after which you will probably be able to go back to most of your daily normal activities.

How soon can I get pregnant after the uterus is evacuated?

• Pregnancy can occur as soon as two weeks after the procedure, once your uterus has healed. Ovulation may happen as early as two weeks after the miscarriage. 

• There are no absolute medical contraindications to conception once you are ready to become pregnant again, so you may start trying to conceive when you feel mentally and emotionally prepared.