Dilation and Evacuation (D&E) for Abortion

The risks of dilation and evacuation (D&E) include:

• Injury to the uterine lining or cervix.
• A hole in the wall of the uterus (uterine perforation). This is rare. This most commonly happens during cervical dilation. In the second trimester, bleeding may be more likely, and a repair may be needed. If bleeding is a concern, a Reference laparoscopy Opens New Window (a procedure that uses a lighted viewing instrument) can be used to see whether it has stopped.
• Infection. Bacteria can enter the uterus during the procedure and cause an infection. This is more likely if an untreated infection, such as a Reference sexually transmitted infection (STI) Opens New Window, is present before the procedure. Antibiotics given during and after the D&E procedure will reduce this risk.
• Moderate to severe bleeding (hemorrhage), which is sometimes caused by:
  • Injury to the uterine lining or cervix.
  • Uterine perforation.
  • Uterine rupture. In rare cases, a uterine incision scar tears open when a medicine is used to induce contractions.
  • Tissue remaining in the uterus (retained products of conception).

Risks are higher for surgical abortions done in the second trimester of pregnancy than for those done in the first trimester, particularly if they are done after 16 weeks of pregnancy.

Other rare complications include:

• Tissue remaining in the uterus (retained products of conception). Cramping belly pain and bleeding recur within a week of the procedure. Sometimes prolonged bleeding does not occur until several weeks later.
• Blood clots. If the uterus doesn't contract to pass all the tissue, the cervical opening can become blocked. This prevents blood from leaving the uterus. The uterus becomes enlarged and tender, often with belly pain, cramping, and nausea.

A repeat Reference vacuum aspiration Opens New Window and medicine to stop bleeding are used to treat retained products of conception or blood clots.

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