Duration of Bleeding After Dilation and Curettage (D&C)
After a dilation and curettage (D&C) procedure, it is normal to experience bleeding for approximately 1-2 weeks, though this can vary based on the reason for the procedure and individual factors.
Normal Post-D&C Bleeding Pattern
- First few days: Moderate to heavy bleeding similar to a period
- Days 3-7: Bleeding typically lightens to spotting
- Days 7-14: Spotting usually resolves completely
- Beyond 2 weeks: Continued bleeding warrants medical evaluation
Factors Affecting Bleeding Duration
Procedure-Related Factors
- Type of D&C: Therapeutic D&Cs (for miscarriage or abortion) may cause more bleeding than diagnostic procedures
- Extent of tissue removal: More extensive curettage can lead to longer bleeding
- Surgical complications: Uterine perforation (occurs in 0.9% of cases) 1 may cause increased bleeding
Patient-Related Factors
- Reason for D&C: Procedures for incomplete miscarriage may have longer bleeding than diagnostic D&Cs
- Anticoagulant use: Patients on blood thinners may experience prolonged bleeding
- Underlying conditions: Conditions affecting coagulation can extend bleeding duration
Warning Signs Requiring Medical Attention
- Heavy bleeding: Soaking through more than one pad per hour for 2+ consecutive hours
- Prolonged bleeding: Bleeding that continues beyond 2 weeks
- Severe pain: Increasing rather than decreasing pain
- Signs of infection: Fever, foul-smelling discharge, severe abdominal pain
- Passing large clots: Clots larger than a quarter
Rare Complications to Be Aware Of
- Delayed heavy bleeding: May indicate a uterine pseudoaneurysm, which typically presents 9+ days after the procedure 2
- Asherman's syndrome: Scarring of the uterine lining can occur after D&C
- Retained tissue: Can cause persistent bleeding and may require repeat D&C
Post-Procedure Care
- Rest: Limited activity for 24-48 hours
- Hygiene: Use pads rather than tampons for at least 2 weeks
- Medication: Take prescribed pain medication as needed
- Follow-up: Attend scheduled post-procedure appointments
- Sexual activity: Avoid intercourse, douching, and tampon use for at least 2 weeks
MRI Findings After D&C
MRI studies show that by day 2 after D&C, hypointense curvilinear areas (likely representing clots) are visible in the endometrial canal. By day 7, these areas decrease in size in most patients (62%) or completely resolve in others 3.
Remember that while D&C is a common procedure with generally low complication rates, it's important to monitor your recovery and contact your healthcare provider if you experience any concerning symptoms.