Curettage after a miscarriage

Curettage may be necessary after an abortion or following a biopsy. And in the case we are interested in here, curettage is also performed after a miscarriage. That said, for many women this procedure remains somewhat unclear — both in terms of the name itself, the process involved and any potential consequences. So we are going to walk through all of this in the following lines to make it as easy to understand as possible.

What exactly is curettage?

To start with, curettage following a miscarriage in particular involves inserting an instrument called a curette inside the uterus. This curette resembles a sort of small metal spoon with sharpened edges. This small instrument is used to scrape the walls of the uterus, with the aim of retrieving the endometrial lining — or the intrauterine contents in order to remove the pregnancy or placental debris. Let us now look at how the procedure unfolds.

How does a miscarriage curettage procedure work?

It is worth knowing that the procedure is fairly quick. Indeed, curettage is carried out as a brief surgical gesture lasting around ten minutes or so. Note, however, that even though it is brief, it takes place in an operating theatre. And in most cases under general anaesthetic, though sometimes under locoregional anaesthesia — in other words, an epidural administered to the relevant area. The notable advantage of partial anaesthesia is that it allows the procedure to be carried out on an outpatient basis, meaning you can go home the same day. Let us look at exactly when a miscarriage curettage is performed.

When is a miscarriage curettage performed?

In the context of a miscarriage, curettage may be only a complementary step. Indeed, it is sometimes carried out following a suction aspiration procedure. It is worth noting that the same process applies in the case of a missed miscarriage, or a surgical termination of pregnancy — that is, when the pregnancy is too advanced.

In this case, the curettage will confirm that the aspiration has fully removed the lining. And thus avoid any risk of infection or bleeding. The first step may therefore be aspiration, performed using a tube connected to a machine.

The miscarriage curettage then completes this initial work by removing any remaining debris. Note, however, that the gynaecological surgeon may decide, depending on the circumstances, that curettage should be performed directly. Of course, any surgical procedure may carry some risks.

What are the possible risks following a curettage after a miscarriage?

In the case we are discussing here, to perform the curettage, the doctor will need to dilate the cervix. At the moment of this dilation, or during the curettage itself, it can happen — in around 1% of cases — that some lesions occur in the uterus. If this does occur, a laparoscopy is performed to assess the lesions and, if necessary, to suture the uterus and any other affected organs.

It is also worth noting that, to avoid any risk of infection caused by germs travelling up into the uterine cavity (and despite disinfection of the cervix and vagina), antibiotics are automatically administered intravenously. Finally, it is worth keeping in mind that complications such as infections or significant bleeding remain extremely rare.

A few precautions after the procedure

In the days following the procedure, you may notice some light bleeding, which is perfectly normal. However, if the bleeding is heavy, has an unpleasant smell, or contains discharge, and is accompanied by abdominal pain and a feeling of feverishness —

it is very important to seek medical advice promptly. As far as everyday habits are concerned, it is recommended that you avoid baths until the cervix has closed again. The same applies to sexual intercourse. Allow around ten days to abstain from these things — at the very least, until you have had a follow-up appointment with your doctor.