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D and C (Dilation & Curettage) After a Miscarriage/Abortion
Dilation and Curettage (D and C) is a surgical procedure through which a physician explores the uterine lining and the inside of the uterus. The recovery phase is short. However, there are some risks which a patient may have to face, but they are rare.
What are Dilation and Curettage?
Dilation refers to the widening or opening of the cervix and Curettage refers to the procedure when the lining of the uterus or the contents of the uterus are scraped and scooped out. The D and C surgery is performed after a miscarriage in the first trimester or in case of an abortion.
Why You Need a D and C Surgery?
A 'D and C' procedure is carried out to diagnose the gynaecological reasons which cause heavy, abnormal uterine bleeding. It is also used to understand and identify the presence of cancer or to analyze the reasons behind a woman’s infertility. The procedure is also used to remove the excess uterine lining in women who suffer from polycystic ovary syndrome.
It is also done in case of a missed or incomplete miscarriage. A 'D and C' procedure for miscarriage uses suction to remove the uterine contents. It is used after a miscarriage to pull out the fetus and the other tissues in case the contents have not come out on their own. For healing after a miscarriage
Reasons for Not Performing Dilation and Curettage?
A 'D and C' is performed to ward off infections in the uterus and for gynaecological conditions. Although, it should not be done under the following conditions listed below:
A person who is too sick to undergo surgery should not undergo this procedure.
It should not be done on people suffering from severe arthritis who may be unable to move their legs apart to allow a speculum inside.
In case a person is pregnant or assumes that she is pregnant, D and C should not be carried out. It can only be done in case the woman wants to abort the baby, or she has had a miscarriage.
Preparation Needed for Dilation and Curettage
Follow exactly the way your doctor asks you to. However, there are few things you need to do on your own like –
One should avoid drinking and should not eat anything on the day of the surgery.
Before getting the procedure done, you should get yourself thoroughly examined.
To start opening your cervix get the gel applied a day before the procedure by your doctor.
Do get someone with you to drive you back home after the procedure.
Which Type of Anaesthesia is Required for D and C?
There are different types of anaesthesia that can be used during D and C. However, it is up to the patient and the anaesthetist what they want to choose.
1. General Anaesthesia
It is a medically induced coma. It can be administered as an inhaled gas or through an injection. This is the most common among all types of anaesthesia in a D and C procedure.
2. Spinal Anaesthesia
Spinal anaesthesia is a type of regional anaesthesia into the subarachnoid space through an injection. The drug is injected with the help of a very fine needle. The best part about spinal anaesthesia is that though the patient is wide awake, she does not have any sensation down below the waist.
Another form of spinal anaesthesia is the epidural anaesthesia. In this type, the drug is injected at a slightly different place in the spine. It eases the pain keeping the lower limbs active.
3. Local Anaesthesia
Here a small part of the body where the incision is to be made is made numb. The drug is injected into the part of the body where the incision is to be made. This form of anaesthesia is rare in a D and C procedure.
What Happens during D And C Procedure?
A 'D and C' procedure is a minor surgery in which a patient can go home on the same day after the surgery. The following are the steps to the procedure.
1. On Reaching the Hospital
Once you reach the hospital, the first thing you will be asked to do is empty your bladder and wear the hospital gown.
2. Anaesthesia
The nurse will then ask you to lie down, and the doctor will start administering the anaesthesia.
In case of local anaesthesia, the doctor will insert the speculum into the vagina and clean the inner as well as the outer vagina including the cervix with an anti-bacterial cleaning solution. Then on getting the cervix steady with a clamp, he will administer the drug on both the sides of it.
If the patient is being administered spinal anaesthesia, the drug is injected into the spinal fluid through the back.
The patient will not be aware of anything if administered general anaesthesia. In this case, the patient will be made to lie down and given an intravenous anaesthetic drug which will make the patient fall asleep immediately. The breathing will be monitored throughout the procedure.
3. Dilation
During this procedure, the doctor first tries to understand the depth and the angle of the uterus. He does so by inserting a thin flexible piece of metal. Then he inserts a speculum; an instrument used to hold open the vaginal walls. Then he inserts a series of tapering rods, each thicker than the previous one to stretch the opening of the uterus.
4. Curettage and Hyteroscope
Once the cervix is dilated, a spoon-shaped device called a Curette is inserted into the uterus. After scraping a little of the cervical lining, the doctor will then insert a hysteroscope. Through this instrument, the doctor can get to see the inside of the uterus to look for overgrowths in the endometrium. If in case, there are polyps or fibroids, the doctor can remove it then. Hysteroscopy in D and C is usually done to evaluate the cause of the abnormal uterine bleeding and even to rule out malignancy in menopausal patients.
The procedure takes less than 30 minutes only and the recovery time is about 24 hours maximum.
D and C Side-Effects & Risks
D and C is usually a very safe procedure. However, on rare occasions, patients may experience few side-effects and risks.
In case a patient is administered general anaesthesia, he may feel a bit disoriented after getting back to his senses.
The patient may experience cramping for the next few days after undergoing a D and C surgery. This is due to the uterus being scraped and suction applied to pull out the tissues and the uterine contents.
Haemorrhage or heavy bleeding may occur rarely in cases of injury in the uterine wall by the instruments, or in case an unknown fibroid is cut during curettage.
While conducting the procedure, the uterus may be injured.
The Asherman’s syndrome may occur in very rare cases. In such a case there will be the formation of scar tissues in the uterus. Normal mensuration may be affected, and it may also cause problems in conceiving.
Infections can occur since instruments are inserted into the uterus.
Uterine perforation may be a case if the patient is suffering from an infection in the uterus during the procedure. This is usually very rare. It also occurs in elderly post-menopausal women and patients who have had a miscarriage.
At times when the procedure is not done using a hysteroscope, a polyp or a fibroid may go undetected.
Recovery After Dilation and Curettage
The minor surgery takes about 15-20 minutes and D and C recovery time are also less, unlike other surgeries. You may have to stay for a few hours after the surgery for observation. Only in rare cases, the patient may have to be hospitalized. You may experience lightheadedness for a day or cramping for few days after the D and C procedure. Therefore, you have to have someone to drive you back home from the hospital. The patient may experience light bleeding or spots. You could also suffer from Anaemia due to excessive blood loss during the procedure. Anaemia could cause weakness and heavy breathing. This can be cured by taking iron tablets. All in all, the patient can start her normal routine of doing household chores or going to work in a couple of days. Some may even start as early as the day after the surgery.
How to Take Care of Yourself At Home?
Taking care of yourself after a 'D and C' procedure is imperative. Here are 7 tips on how to do so:
Taking adequate rest and getting enough sleep will help you recover soon.
Avoid strenuous activities like lifting heavy weights, running, cycling etc. until your doctor gives the nod.
Eat a nutritious and normal diet until you have been asked by your doctor not to.
Do not use tampons until your doctor allows you to. Instead, use a sanitary napkin in case of bleeding.
Stay away from intercourse for at least 2 weeks after the surgery.
Do not conceive till your doctor says you can.
Drink plenty of fluids.
Take painkillers as prescribed by your doctor.
Take a full course of the anti-biotic as have been prescribed by your doctor. Do not stop taking them just because you have started feeling better.
In case of any discomfort, be sure to consult the doctor immediately.
When to Seek Medical Help?
You should call for medical help anytime you feel uncomfortable. However, here is a list of signs you should look out for after a D and C surgery.
You have chest pain or trouble breathing.
You cough up blood.
You experience heavy vaginal bleeding and may have to change one or more than one pad in an hour.
You have a vaginal discharge with a foul smell.
When even a painkiller does not relieve the pain.
You are sick to your stomach and unable to drink any kind of fluid.
You have signs of infection like pus draining from the area, severe pain, swelling and warmth in the area.
You have symptoms of blood clot in your leg like a pain in your calf, back of the knee, thigh or groin and swelling.
FAQs
Here are a few frequently asked questions of people which may help you to get an answer to your queries.
1. What If My Bleeding After D And C Stopped And Then Started Again?
Bleeding for some time and then not and then bleeding again for the first four weeks after D and C is perfectly normal. It is just your hormone trying to regulate itself. Moreover, even after scrapping and scooping in the D and C procedure, a lot of uterine lining is still there to be shed which comes out through the bleeding.
2. Can I Get Pregnant After D and C?
Yes, it is absolutely possible to get pregnant after a D and C. However, it is wise to wait for your body to heal before you try to conceive again.
3. When Will I Have My First Period After a D And C Procedure?
It takes about 4 to 6 weeks to get your first periods after a D and C procedure. The first flow after the D and C is different for different people. However, it is usually heavier than usual but nothing to be worried about.
Advances in the field of medicine have provided an alternative treatment to the traditional method of D and C. However not all doctors are trained or equipped to try out these alternatives. Therefore, the D and C procedure will continue to be the standard diagnostic or therapeutic method for gynaecological conditions.
Also Read: How To Take Care Of Yourself After An Abortion Read more
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6 Ideas To Stop Food Wastage By Kids
Children tend to take things, like food on the table, for granted, and that leads to a whole lot of wastage. We feel bad about food being wasted in our own homes, but don't always know what to do about it. Try out some fresh ideas to cut down on food wastage!
Children generally don’t worry much about wasting food. They eat what they want and how much they want to, leaving the rest without thinking about it. As a parent, it’s up to you to curb the habit of wasting food. Children need you to teach them why they shouldn’t throw it away, and why they don’t need to overfill their plates. Teach them when they’re young and this thought process will stay with them throughout life.
How To Stop Children From Wasting Food?
1. Keep The Portions Small And Manageable
Teach your children to put smaller portions on their plates, without piling them up in one go. Make them understand that it’s okay to take second, third, or fourth helpings. They may fear that food will run out and fill up their plates at one time. They need to be taught that there’s more if they want it. Once they learn, wasting food in school and at home will be reduced.
2. Save The Leftovers
If your kids have wasted food, you don’t necessarily need to throw it out. Kids have smaller appetites, but with all the activity they do they get hungry sooner too. You can save their leftovers in child-friendly containers for them to finish later. Naturally, you won’t feed them items that are three days old! It’s just for the next meal. You can also use leftovers to create another dish. For instance, leftover pasta can be used to make pasta salad.
3. Plan Ahead
Try and plan ahead when you go grocery shopping. Involve the kids in meal-planning and you’ll save time, money, and reduce food waste. Skip items that they don’t like to eat and replace them with a healthy alternative. For example, if they find cauliflower boring, you could get broccoli, beans and peas.
4. Make Food More Interesting For The Kids
Children don't mind eating veggies and fruits if only they look attractive! Make sure you use colourful plates and cutlery and present meals using kid-friendly themes such as Disney. Even when you are packing their lunch-boxes, try and be as creative as possible. We promise empty tiffins when the kids return home!
5. Introduce Them To The Process of Growing Food
Educate your kids about food. Show them how it grows. Plant a few herbs with them so they realise the effort that goes into growing food. Plan meals you can cook together, and that your kids can help you with such as mixing, and whipping and measuring. They’ll learn to appreciate food more.
6. Show Them The Reality of Food Wastage
Teach your children not to waste food. Explain to them what happens when they throw away food, and help them appreciate how lucky they are not to go hungry. Drive home the point with food waste facts for kids and tell them that it’s morally wrong to throw away good food that less privileged people would be grateful and thankful for.
Let's aim to raise socially-conscious and caring children who consider other people and the environment before taking any action. Be the socially sensitive family! Read more
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How to Make Yourself Happy - Tips to Sense Joy and Well-Being in the Present Moment
Happiness is one of the most underrated things in life. Many people tend to forego sustainable happiness for a lot of reasons, ranging from other pleasures to even money matters. However, the fact remains that happiness is one of the most important things in life because it can impact your well-being.
How can you be happy? Some simple ways to be happy are mentioned below
Simple Ways to Make Yourself Happy
Here are some answers as to how to make yourself happy when you alone, and some also deal with making yourself happy in a relationship.
1. One Nice Thing
Many people commit to doing a nice thing every day – while this is great, it is important to doing something nice for yourself too. No matter how big or small, a nice thing is a nice thing – you will feel happier after you do it. Do not think about whether you deserve it or not – just do it anyway, for yourself.
2. Listen to Yourself
Observe how you talk to yourself – this may not necessarily be out loud, but can also be an internal voice too. Do not be harsh when you criticize yourself and learn to talk about yourself in a more loving tone since this can have an impact on your happiness too.
3. Forgiveness
Everyone makes mistakes – it is part of human nature. If you hold yourself to a high sense of accountability, great; however, that does not mean that you do not make mistakes too. You should learn to forgive yourself in order to move on in life, and become happier with yourself.
4. Accept Yourself
Understand that you are not some sort of Superwoman, even though you may be trying to be. Everyone around you is flawed, including yourself. Avoid beating yourself up too much without understanding those facts. Understand that you are free to make your own path, and are not accountable to anything else, like a career path or money. Embracing yourself is one of the biggest steps to ensuring long-lasting happiness.
5. Eliminate Toxicity
You do not have to be around anyone who is toxic, according to you. Be it clients, business partners, investors, employees or even friends, minimise interactions with those you think have a negative impact on your life. You do not have to put up with unkind people in your life.
6. Your Health
Your physical health impacts your mental well-being too. Therefore, you need to prioritise your health in many ways in order to be happy in a sustainable manner. However, ensure that you can take the occasional cheat days too if you follow a strict diet or the likes.
7. Meal-Skipping
This is one of the largest problems of the current generation. More and more people have started to skip meals because they are busy, and this has a bad impact on the mental and physical health of the person. Just try to eat something, regardless of what it may be – it could be something as simple as a salad, but it can help your body function better.
8. Breathe
Whenever you feel anxious, distressed or upset, remember to take a few deep breaths before you make a decision. This can help you calm yourself down, and help you get your thoughts in order before you have to act. It also improves the happiness quotient of the person in a dramatic fashion.
9. Welcoming Space
Try to do simple things around your house before you are tired, so you do not have to burden yourself when you actually arrive tired and stressed. Simple acts, like making your bed in the morning can be a boost to you when you come back from work all overworked and tired. Take control of your environment, and consequently, become happier.
10. Light It Up!
Many people tend to prefer dark spaces to work in. While this may be okay for short periods, it is important that you expose yourself to sunlight. You are sure to feel the warmth not only on your skin but also on your mind too – these can help you stay happier throughout the day.
11. Pamper Yourself
This does not mean that you have to become a shopaholic, but buying the occasional premium product for yourself can truly make an impact in your mind. Make yourself happy by treating yourself to a present, and take control of your own happiness. Most people tend to spend money on their loved ones, but never on themselves. Understand that you are your own loved one too and that the occasional expensive gift to yourself is not going to matter in the long run.
12. Jumping Jacks
If you are feeling particularly down, try to do some simple aerobic exercise like jumping jacks. These have been found to boost the mood of the person and can help you cope with any stress that you may be feeling. In fact, aerobic exercise has even been found to be an effective treatment for moderate depression.
13. Call a Friend
After all, is said and done, it is a fact that man is a social animal. Everyone needs some sort of interaction with friends and family every day, in order to be happy and healthy. Personal relations are important in a huge manner, and they can have a lasting positive effect on the person too. Say hi to your family, or walk up to a friend and have a personal conversation for some time.
14. Be Grateful
Ideally, you should maintain a journal in which you should write down something which made you thankful for being who you are every day. Acknowledging your good fortune and understanding the results of your labour has been found to be a huge factor in making you happy, and this has been found to be a cornerstone of positive psychology. In fact, having this habit for more than 6 months can drastically improve your mental and physical well being.
15. Imagine
When you are nervous about the outcome of anything before doing it, try and imagine the best case scenario for yourself rather than the worst one. Project your best possible self to yourself, and understand the capabilities you have when you are the best version of yourself. This is a tip which can truly change your life, owing to the results it can have on your health. Even pretending to be an optimist can fool your brain into calming your body down effectively – this can possibly translate to better results in whatever you are planning to do, and helps you control the outcome better.
Being happy is extremely important for any person since it impacts all facets of human life. You should try to be as happy as possible when you can, even when things are not going particularly well. Remember that everyone is flawed, so you do not have to be perfect in this world in order to succeed.
Also Read: Work-Life Balance Tips to Follow for Healthy and Beautiful Life
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How To Teach Goal Setting to Children - 6 Effective Tips
People who set goals in life are not only driven to achieve them, but they achieve them too. A person who has a purpose in life has a reason to get up and work for it. Even kids should be taught about setting goals in life and working for them. If you set monthly or yearly goals, it is suggested that you pass on this habit of yours to your child as well. Whether it is about setting academic goals or other goals, teach your child about setting a goal from an early age. If you are wondering how you can teach him, read this article. This article describes what goal setting is and how one can teach it to children about it.
What Does Goal Setting Mean?
Goal setting is planning for the future. For example, if a child makes a plan to study for his test or prepare for his big basketball game, then this is 'goal setting'. Similarly, if a child decides that he wants to become a pilot in the future, then this is his goal of life. We set goals in life, but we don't really work for them. To achieve any goal, proper planning and consistent efforts are necessary. Therefore, planning for how you will achieve a particular target or goal is what goal setting is all about.
Why Is Goal Setting Important for Kids?
Goal setting gives a purpose or direction to kids. This way your child knows what he is expected to do to achieve a particular target. This will increase his self-esteem, focus, and even help him in making better decisions. It is also observed that kids who have some goals to look forward to, tend to perform better than kids who do not have any goals in their lives.
How to Help Your Child in Goal Setting
Here are some ways that you may follow to teach kids about goal setting:
1. Start Small
When you start teaching your child about goal setting, start with small goals. You can set monthly or weekly goals and then gradually move to bigger goals. His small achievements will make him happy and he will be determined to set other goals and motivated to work hard for them.
2. Let Your Kid Follow His Dreams
It is very important that what you want your kid to achieve should be of his liking too. Imagine if your kid wants to be a cricketer and you integrate his efforts into becoming a good pianist. This may not work and will only draw you apart from your kid. Let your child discover his passion and help him work for it.
3. Lead By Example
Kids love to follow their parents, and if they see you doing something, chances are they may do it too. So, involve your kid in your planning strategies too, of course, the ones that are age-appropriate. If you are making a new kitchen garden, you can involve your kid in planning for the same. He will enjoy planning with you and he will also learn the act of planning with you.
4. Give a Reality Check
Kids are not matured enough to understand the importance of hard work in order to achieve something. Your child may often underestimate the amount of effort that may be needed to achieve a particular goal. And if he fails, it is obvious for him to get discouraged or frustrated. But it is very important that you explain the challenges that your child may be required to face. Explain him that if he falls, he has to get up and work again. Teach him that he should not quit in between and work hard if he fails.
5. Praise His Efforts
It is very important to keep your kid motivated throughout the journey. In the absence of proper appreciation and motivation, your kid may lose interest. Therefore, do not forget to praise and appreciate your kid for his efforts.
6. Consider the Obstacles
Just the way it is important to set a goal, it is also important to discuss various obstacles or problems that your child is likely to face while achieving those goals. Talking about obstacles will prepare your child better. Also, if certain setbacks are incurred during the journey, he will work harder to achieve them. It is important to assess the approach and establish the necessary amends that need to be made.
Fun Goal Setting Activity for Kids
Here are some goal setting games for kids that your child may enjoy and learn from:
1. Make a Vision Board
Ask your kid to cut out different pictures from various magazines and periodicals, which represent his dream. Paste these pictures on a board and place the board in your child’s room. Seeing this every day may help your kid become more focused for his dreams.
2. Play a Fun Question Game
Ask your child questions related to his goal as it would give you an idea of what he wants in life and you can help your kid understand better. For example, ask your kid what he should do if he wants to score good marks in a particular subject? If he says 'study and practice', then you know your child is on the right path. However, if he does not work hard, you need to make him understand that if he does not study he will never get desired marks. Explain in a gentle tone and he will understand.
3. Make a Wheel of Fortune
Make a wheel and divide it into sections. Write different categories such as academics, sports, family etc. Let your child choose anyone and then set goals towards achieving it. For example, if he has chosen academics, ask him how he will go about it. He can plan to study 3-4 hours daily and take a weekly test. Let him colour the academics section on the wheel so he can see it every day and motivate himself to work hard.
4. Make a Bowl of Dreams
Gather all the family members and write their aspirations, dreams, and goals (they want to accomplish in that year) on different pieces of paper and place it a jar or a big glass bowl. Keep this bowl at a place where all the members of the family can see it every day as it will remind them to work for their goals. At the end of the year or after a stipulated period take out the papers and read out the goals of each family member and ask them if they accomplished it or not.
5. Play Wish and Stars Game
This is a very interesting game. Ask your child to choose three things that he may be best at and make those activities or qualities, his ‘stars’. Later ask him about the qualities he needs to master and make those his ‘wishes’. Your kid's ‘wishes’ can become his goals and you may help your kid in achieving these goals.
It is important to help your kid plan his life rather than just wait for the things to happen on its own. With the above-mentioned tips, we hope you and your child will have a great time understanding goal setting. With these tips help your child in goal setting and see him succeed in life.
Also Read: How to Teach Child to Share Read more
Dr Vandan H Kumar has added a new answer
Guardian of 0 children
2 hours ago
Q. Is it okay if my baby does not pass stool for one day?
Dr Vandan H Kumar
Paediatrician
1 hour ago
A. no need to worry about the frequency and colour of the stool if the consistency of the stool is semi solid to solid.
also there is no need to worry about the smell of the stool if the consistency is normal.
you have to meet the doctor if it is watery inconsistency or hard consistency otherwise semi solid to solid stool is normal.
also passing stool after taking food is normal. r
Rashmi has added a new answer
Expecting Mom due in 6 months
2 hours ago
Q. Q.Asktheexperta# I m an expecting mother of 29 yrs. LMP 10 Feb 2024 . my husband's HPLC report shows thalassemia minor trait while mine is hb d Punjab trait . can we continue with this pregnancy ??
Rashmi
Mom of a 9 yr 7 m old girl
2 hours ago
A. Well you should check with your gynaecologist for that she has to go through all the reports and the issues that you are facing you and your husband and accordingly she can tell you what is the situation how your child is going because lot of things depend upon how the child is growing
Dr Sameer awadhiya has added a new answer
Expecting Mom due in 1 month
1 hour ago
Q. Hi doctor, I had scan on 33 weeks 2 day, it stated that AC and HC Is <2.3% which is corresponding to 31 weeks. So overall growth of baby avg is 31 week and 2 days.
will there be any issue with the baby.I have attached my report
Dr Sameer awadhiya
Paediatrician
5 mins ago
A. For the query asked needdhs consultation with doctor for proper guidance so it is better that the doctor will guide you the correct way .
Online consultation can also be taken and the expert will give you the proper answer .
Dr Ghouse has added a new answer
Guardian of 0 children
34 mins ago
Q. I am having pain on my right breast while breastfeeding. Latching position is correct. it is a mix of burning sensation and pain. Pain lasts for few minutes after breastfeeding also
Dr Ghouse
Paediatrician
32 mins ago
A. nipcare ointments ok. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Dr Ghouse has added a new answer
Expecting Mom due in 4 months
32 mins ago
Q. When baby movement starts??
Dr Ghouse
Paediatrician
6 mins ago
A. 5-6 months ok. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Dr Ghouse has added a new answer
Expecting Mom due this month
9 mins ago
Q. hello dr..I am 39 weeks 3 days pregnant, AFI level 8 is this normal?and normal delivery possible for me? Is the fluid enough for up to 1 week?Do I need a drip? please suggest me.
Dr Ghouse
Paediatrician
5 mins ago
A. the levels are on the lower side. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
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