59840 Induced abortion, by dilation and curettage

Name of the Procedure:

Induced Abortion by Dilation and Curettage (D&C)

Summary

Induced abortion by dilation and curettage (D&C) is a medical procedure used to terminate a pregnancy. It involves dilating the cervix and then inserting a special instrument to remove the contents of the uterus. This procedure is commonly done in the first trimester of pregnancy.

Purpose

This procedure addresses unwanted pregnancy, pregnancy complications, or certain health conditions that necessitate termination. The goal is to safely and effectively end the pregnancy while minimizing complications for the patient.

Indications

• Unplanned or unwanted pregnancy.
• Pregnancy complications that risk the mother's health.
• Diagnosis of fetal anomalies.
• Missed or incomplete miscarriage.
• Molar pregnancy.

Preparation

• Patients may be required to fast for a few hours before the procedure.
• Pre-procedure medications may be given to soften the cervix.
• A pelvic exam and ultrasound might be conducted to assess the pregnancy.
• Patients should arrange for transportation home as they might feel drowsy post-procedure.

Procedure Description

1. Sedation/Anesthesia: Patients are given local anesthesia, conscious sedation, or general anesthesia based on individual needs.
2. Dilation: The cervix is gradually dilated using medication or a series of dilators.
3. Curettage:
   • A special instrument called a curette is inserted through the cervix.
   • The curette is used to gently scrape the uterine lining and remove the pregnancy tissue.
4. Ultrasound Guidance: In some cases, ultrasound imaging is used to ensure all tissues are effectively removed.

Duration

The procedure typically takes about 15 to 30 minutes.

Setting

Induced abortion by D&C is often performed in a hospital or outpatient surgical center.

Personnel

• Obstetrician/Gynecologist (OB/GYN)
• Nurse or medical assistant
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Common risks: Cramping, mild bleeding, nausea.
• Rare risks: Infection, heavy bleeding, perforation of the uterus, damage to the cervix, scarring within the uterus.

Benefits

• Effective termination of pregnancy.
• Rapid recovery time.
• Resolution of pregnancy-related health complications.
• Relief from the emotional burden of an unwanted pregnancy.

Recovery

• Patients may rest in a recovery area for a few hours post-procedure.
• Pain management can involve over-the-counter pain relievers.
• Instructions typically advise avoiding strenuous activities and vaginal insertion (e.g., tampons, intercourse) for a specified period.
• Follow-up appointment may be scheduled within a few weeks to ensure complete recovery.

Alternatives

• Medical abortion: Involves taking medication to end the pregnancy.
• Vacuum aspiration: Another method to remove the contents of the uterus.
• Carrying the pregnancy to term and considering parenting or adoption. Consider discussing these options with a healthcare provider to understand the pros and cons.

Patient Experience

• During the procedure: Patients may feel pressure or mild discomfort due to dilation.
• After the procedure: Some cramping and bleeding similar to a heavy period are common.
• Pain management: Includes medications and rest, with attention to personal comfort and recovery needs.