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Dilation and Evacuation

Surgery Overview

Vacuum aspiration can be used to empty the uterus after a miscarriage or other fetal loss. Many miscarriages pass on their own, but some do not. These are called incomplete miscarriages and missed miscarriages. With an incomplete miscarriage, some of the pregnancy tissue stays in the uterus after a miscarriage. With a missed miscarriage, all of the tissue stays in the uterus after a miscarriage.

You may have manual or machine vacuum aspiration. With manual vacuum, the doctor uses a specially designed syringe to apply suction. With machine vacuum, a thin tube is attached to a bottle and a pump. The tube is inserted into the uterus. The pump provides gentle suction to remove the tissue.

After the procedure, you may have bleeding and spotting. You also may have cramps that feel like menstrual cramps. Guilt, anxiety, and sadness are common reactions after a miscarriage. It is also common to want to know why a miscarriage has happened. Hormonal changes during pregnancy can make emotions stronger than usual. These feelings can last a while.

What To Expect

Vacuum aspiration is a minor surgical procedure. A normal recovery includes:

  • Irregular bleeding or spotting for the first 2 weeks. Use sanitary pads until you stop bleeding. Using pads makes it easier to monitor your bleeding.
  • Cramps similar to menstrual cramps. You may have them for several hours and maybe for a few days, as the uterus shrinks back to its non-pregnant size.

After the procedure:

  • If your doctor prescribed medicines, take them as directed.
  • Rest quietly for the day. You can do normal activities the next day, based on how you feel.
  • Acetaminophen (such as Tylenol) or ibuprofen (such as Advil) can help relieve cramping pain. Be safe with medicines. Read and follow all instructions on the label.
  • Ask your doctor when it is okay for you to have sex. If you don't want to get pregnant, use birth control when you start having sex again.

Why It Is Done

Vacuum aspiration is done in the first trimester of pregnancy.

Vacuum aspiration can be done for:

  • An induced therapeutic abortion.
  • A failed or incomplete medical abortion.
  • Death of the embryo or fetus (also called spontaneous abortion or miscarriage).

How Well It Works

First-trimester surgical abortions are safe and effective and have few complications.

In rare cases, an aspiration procedure doesn't successfully end a pregnancy. This is more likely to happen during the earliest weeks of a pregnancy.

Risks

The risk of problems from the procedure is rare. But some problems may include:

  • Failure to end the pregnancy.
  • Tissue remaining in the uterus (retained products of conception).
  • Injury to the cervix.
  • A hole in the wall of the uterus (uterine perforation).
  • Heavy vaginal bleeding.
  • Infection.

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