Unfortunately, most of the time uterine curettage is performed during a delicate moment in a woman’s life: miscarriage. A spontaneous miscarriage can occur for various reasons, and sometimes a medical intervention is needed to remove what the body could not expel on its own. Incomplete miscarriages require uterine curettage, and it must be performed in a hospital by a gynecologist.
To cope with the loss caused by a miscarriage, having psychological support is essential. Therefore, I recommend seeking out a psychologist with experience in supporting women who are trying to conceive. During pregnancy, several changes occur in the uterus1. The endometrium grows significantly and becomes thick to accommodate the embryo in its early stage. In some cases, the body is not able to eliminate all the endometrium after a spontaneous miscarriage. If the pregnancy is more advanced, there are also cases where it is necessary to remove remaining placental tissue. There are even situations where the body does not expel the fetus at all, and curettage is necessary. Curettage is not an easy process, and it is normal to feel afraid. The situation is very painful, but curettage is necessary to prevent anything from remaining in the uterus after a partial expulsion2. Retaining tissue from a pregnancy that did not progress can cause very serious infections. Undergoing curettage is unpleasant, but it is safer than having to deal with the consequences of a partial expulsion.
How is uterine curettage performed?
Curettage is performed in a hospital or maternity hospital, generally in a surgical center appropriate for the procedure. Instruments are used to dilate the cervix and others to perform the actual cleaning. The most common methods are scraping (the conventional one) or suction (a more modern method). The patient undergoes anesthesia that depends on her physical and emotional state. In most cases, it is a spinal anesthesia. Intravenous sedation (general anesthesia) may also be used, but the on-duty anesthesiologist will determine the best option for each case. Curettage is simple, and depending on each patient’s health condition, discharge from the hospital may be within 12 to 24 hours. The material collected during curettage will be analyzed to determine the reason for the miscarriage (anatomopathological analysis). Cases of recurrent miscarriage are the main indication for a post-curettage uterine biopsy. There is also a more detailed test called cytogenetic analysis, which is carried out at the woman’s discretion. Curettage is not only performed in cases of miscarriage. There are other situations where it is needed, such as in cases of frequent severe bleeding and strong abdominal pain. If the bleeding does not stop on its own, a curettage may be indicated in extreme cases. Many women confuse the word ‘coletagem’ with curettage. ‘Coletagem’ comes from ‘collecting’ and has no connection to the act of uterine curettage.
Recovery from uterine curettage
Recovery is relatively simple, but each case is different. Curettage after miscarriage in very early pregnancies theoretically has an easier recovery. Cases of more advanced pregnancies usually require longer recovery times. Sometimes, rest is prescribed just like after a vaginal delivery, that is, 40 days. After curettage, relative rest is necessary, with no physical exertion or sexual activity. Full recovery is expected, without unpleasant complications. After curettage, the doctor may prescribe anti-inflammatories or specific antibiotics as needed. Bleeding persists even after curettage, and this is perfectly normal. This blood is the result of the body’s own cleaning to finish the invasive process. Bleeding after uterine curettage can last from 5 to 15 days, depending on each woman’s body. It is recommended to see a doctor if the bleeding continues beyond this period or if there is any fever, chills, or intense abdominal pain. In such cases, further evaluation is needed. Getting pregnant after curettage is a recurring question3. It should be kept in mind that this is not a very common situation and must be evaluated by the doctor. In general, the recommended period before trying again is about three months. In cases of miscarriages during more advanced pregnancies, the waiting period to try again is a little longer, four to six months. Remember: curettage is a way to remove residues from the uterus and should be seen as a natural event. However, it is still an invasive procedure and rest after uterine curettage must be strictly observed. During this period, there are still small wounds in the uterus, and it is essential to wait for proper healing.
Author’s note
In the year 2000, I had a miscarriage at 11 weeks of pregnancy, and I needed a uterine curettage to remove the remains of a pregnancy that had stopped developing. It was a very sad moment, but despite everything, I knew it was necessary. When I arrived at the hospital, they did an ultrasound which showed that there was still a lot inside my uterus, including the fetus, already over 8 cm and without a heartbeat. It felt odd to be in that operating room, but in the end I saw almost nothing. The anesthesia was local and I was sedated for the procedure. I had no pain during or after, nor did I bleed for long after the procedure was performed. But the mark of the event is there forever. I will always remember this difficult time in my life.
Readers’ Questions:
Does the curettage procedure hurt?
The curettage procedure is completely painless, since a sedative is given. In most cases, the anesthesia used is spinal anesthesia. The doctor will indicate the ideal anesthesia for your case during your consultation.
Do I need to bring personal items for after the curettage procedure?
Since hospitalization is usually required after the procedure, it is recommended to bring items such as pajamas or a nightgown. It is also recommended to bring personal hygiene items such as sanitary pads, underwear, toothbrush, hairbrush, etc. Typically, hospitalization is only for one day to monitor bleeding and the woman’s recovery. Also see: Menstruation With Clots – What Is Happening?
