dilation and evacuation

surgery overview

vacuum aspiration uses gentle suction to empty the uterus after a miscarriage. many miscarriages pass on their own, but some don't. with an incomplete miscarriage, some of the pregnancy tissue stays in the uterus. with a missed miscarriage, all of the tissue stays in the uterus.

you may have manual or electric vacuum aspiration. with manual vacuum, the doctor uses a specially designed syringe to apply suction. with electric vacuum, a thin tube is attached to a pump that provides suction.

after the procedure, you may have bleeding and spotting. these symptoms usually don't last more than a few days. you also may have cramps that feel like menstrual cramps. cramping may last up to a few weeks.

it's common to have many different emotions after a miscarriage. it's 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 awhile.

what to expect

vacuum aspiration is a minor medical 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. they help to shrink the uterus back to its non-pregnant size. you may have cramping for up to a few weeks.

after the procedure:

• if your doctor prescribed medicines, take them exactly as directed.
• rest as much as you can. you can do normal activities the next day, based on how you feel.
• ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (tylenol) or ibuprofen (advil). do not take aspirin unless your doctor prescribed it. be safe with medicines. read and follow all instructions on the label.
• ask your doctor when it is okay for you to have vaginal sex.

  you can get pregnant in the weeks after an abortion. if you don't want to get pregnant, talk to your doctor about birth control options.

why it is done

vacuum aspiration can be done in the first trimester to end a pregnancy. it may also be done to empty the uterus after:

• a failed or incomplete medical abortion.
• death of the embryo or fetus (miscarriage).

how well it works

vacuum aspiration is a common type of surgical abortion. it is usually effective. in rare cases, the procedure doesn't end a pregnancy. this is more likely to happen during the earliest weeks of pregnancy.

risks

vacuum aspiration rarely causes any problems. possible problems include:

• tissue remaining in the uterus.
• failure to end the pregnancy (when it's used for abortion).
• injury to the cervix.
• a hole in the wall of the uterus (uterine perforation).
• heavy vaginal bleeding.
• infection.