The medical termination of intrauterine pregnancies is called curettage. Curettage is most commonly used to terminate unwanted pregnancies.
Each country's legal curettage limit is different. In our country, curettage can be done until 10 weeks (according to first day of last mestrual period) to terminate unwanted pregnancies.
Curettage is a surgical procedure. It is performed under sterile conditions with local or sedation anesthesia. Today, the vacuum technique is most commonly used for curettage. Vacuum technique is an effective and safe method in curettage applications. Curettage can be done with this technique for 5 weeks ( according to first day of last mestrual period) and over pregnancy
Apart from termination of pregnancy, curettage can also be performed to investigate abnormal vaginal bleeding, biopsy from the endometrium, and removal of subendometrial fibroids and polyps.
Curettage is a procedure performed under sterile surgical conditions under anesthesia. In the past, it used to operate with a spoon-like instrument called a metal curette. However, nowadays, it is performed with the vacuum technique, which is more effective, safe and has low complication rates.
In vacuum technique, first the cervix is slightly dilated, then curettage is performed with special plastic cannulas that are 4-6 mm diameter. This procedure is called Dilatation and Curettage (D&C) in the medical literature. The curettage stages are:
Unwanted pregnancies can be legally terminated until 10 weeks according to Population Planning Law that came into force in 1983 in Turkey. However, this limit may differ in European Union member states and others.
Curettage can be done at the earliest 5 weeks of pregnancy. Pregnancy under 5 weeks is difficult to detect with ultrasound. If curettage is performed on pregnancies under this week, there is a risk that the pregnancy will not be terminated. In addition, the risk of bleeding is higher than between 5-10 weeks.
The most suitable weeks for curettage are the 5-6 th weeks of pregnancy. There is a lower risk of pain, bleeding, rest tissue or continuation of pregnancy when compared to early weeks.
In case of certain fetal anomalies and medical reasons that endanger the mother's life, curettage can be performed for pregnancies over 10 weeks with the approval of 3 physicians.
For curettage approval, the age and marital status of the woman must be known. In our country:
For the curettage procedure, a companion had better accompany the patient on the clinic. Because side effects such as drowsiness and attention deficit can be seen after anesthesia.
If you have a known disease, you can bring documents related to it with you. Before the procedure, the person is asked to fast for 6 hours and not to eat or drink anything, including water, alcohol and cigarettes. Comfortable and loose clothing should be preferred while coming to the clinic.
Unnecessary drugs should be avoided before curettage. Over-the-counter cold, stomach, and constipation medications can increase the risks of curettage.
Inform your doctor if you have diabetes, hypertension and other diseases before curettage. If necessary, your doctor may order blood, urine and other tests before the procedure.
If an infection, bleeding disorder, heart and lung diseases involving the reproductive organs are detected before the curettage, the curettage may be postponed.
After the curettage, the person is kept under observation for 30-45 minutes. There may be symptoms such as nausea, drowsiness, and weakness due to anesthesia. These symptoms go away on their own within 1-2 hours.
Menstrual pain-like complaints may be seen after curettage. There may be vaginal bleeding in the form of spotting for a few days. Cramp-like lower abdominal pain subsides within a few days.
Persons receiving sedation anesthesia should not drive for the first 24 hours. Because drowsiness, fainting sensation, inattention, coordination disorder and delay in reaction may occur due to the effect of anesthesia.
Oral food intake can be started half an hour after the curettage. You can drink water, eat something.
There is no harm in going to the toilet after an curettage. Genital area cleaning should be done from front to back with warm water. Sanitary pads should be used for vaginal bleeding.
It is desirable not to have sexual intercourse for the first 2 weeks. Tampons should not be used for 2 weeks. Vaginal douching should not be applied. There is no need for a special dressing after curettage.
As the uterus will recover and heal within a certain time, obeying the advices will reduce the risk of infection.
10 days after the curettage, your doctor will want you to come back for a check-up. In this control, the uterus is evaluated with ultrasound. Examination is made in terms of rest tissue, continuation of pregnancy or other conditions.
Curettage is a medical intervention. Like any surgical procedure, it has some risks. These risks are: