Dilatation and Evacuation (D&E)
Since this procedure is generally used after 12 weeks (LMP) of pregnancy,
the doctor will often use ultrasound to determine how far along you are
in your pregnancy.
To prepare for the procedure, the doctor will open (dilate) the cervix.
Most women experience some pain, so the doctor may administer a painkiller:
either locally by shots in the area of the cervix, or by a general anesthetic,
or a sedative (which will leave you conscious). The uterus will be scraped
and the unborn child and placenta are removed with medical instruments.
After 16 weeks, the unborn child and placenta are removed piece-by-piece,
using forceps or other instruments, followed by a vacuum curette used
to remove the placenta and remaining tissue.
Possible Complications and Risks of Dilatation and Evacuation
- Perforated uterus (a hole in the uterus) - very rarely.
- Blood clots in the uterus - very rarely.
- Injury to the bowel or bladder - very rarely.
- A cut or torn cervix (cervical laceration) - very rarely.
- Infection - very rarely - medication for the infection, or in rare
cases, repeated vacuum aspiration might be needed.
- Fertility can be diminished in very rare instances as a consequence
- Incomplete abortion - very rarely - pregnancy tissue left inside the
uterus, repeated vacuum aspiration may be necessary.
- Anesthesia-related complications - very rarely.
- Heavy bleeding - very rarely - a hemorrhage develops; medication,
repeated vacuum aspiration, surgery or blood transfusion might be needed.
- Very rarely - emergency treatment for any of the above problems, including
the possible need to treat with an operation, medicines, or a blood
- Very rarely - death.