Obstetric Prognosis

After the D&C procedure, there are possible side effects and risks including:
- cramping
- spotting or light bleeding

Complications such as a damaged cervix and perforated uterus or bladder and blood
vessels are rare. A doctor should be contacted if any of the following symptoms are
experienced after the procedure:
- dizziness or fainting
- heavy or prolonged bleeding or blood clots (over 2 weeks)
- bleeding heavier than a menstrual period; filling more than one pad per hour
- fever
- severe or increased pain
- abdominal tenderness
- foul-smelling discharge from the vagina

In very rare cases, scar tissue (adhesions) may form inside the uterus (called
Asherman’s syndrome). This may cause infertility and changes in menstrual flow.
Surgery can repair this problem, so abnormal menstrual changes should be reported
after a D&C.

Discharge Plan

Medications:
- Paracetamol 500mg tab every 4 hours
- Cefotixin (Monowel) 1 gram via IVTT every 8 hours ANST
- Ventolin 1 nebule every 8 hours

Exercise:

Unless otherwise advised by the physician, it is fine to resume the patient’s normal
daily activities after 24 to 48 hours and exercise routine as soon as she feels like she
is able to. Exercising may help relieve some of the stress, anxiety, or depression that
may come with having a miscarriage.

Treatment:

Like other forms of sepsis, resuscitation with intravenous fluids and antibiotics are the
mainstay of treatment in the emergency department. Vasopressors and blood
transfusions are used as needed. The antibiotic regimen selected should cover all
potential aerobic and anaerobic pathogens. To note, clindamycin should be considered
in patients suspected of harboring a toxin-producing organism, as it appears to have a
direct antitoxin effect. Antibiotics will be stopped after 48 hours if clinical improvement
is evident and there are no signs of pelvic abscess.
Health Teaching:
- Take an over-the-counter pain reliever for pain, if needed
- Rest for 2 days as needed
- Do not drive for 24 hours after the procedure unless specifically told by the
physician that it is okay to do so

Outpatient:
- Make a follow-up appointment with physician

Diet:
- Have a healthy diet

Sexual Activity or Spirituality:

- Do not have sexual intercourse or use tampons and douches until the
physician instructs it is safe to do so
- Be open to family and close friends as a great source of support if grieving