Does dilation and curettage affect future pregnancy outcomes?

The purpose of this study was to determine if dilation and curettage has an effect on future pregnancy outcome.

Retrospective review of the electronic medical records of all patients who underwent D&C between January 1, 2002, and December 31, 2006, was performed. Patients who had one or more subsequent pregnancies were selected and evaluated for pregnancy outcome. Frequency and incidence of subsequent pregnancy complications were determined by Chi square and Fisher's exact tests and compared to reported statistics.

The incidence of postpartum hemorrhage was significantly higher than previously reported averages (p < 0.0004). We found no difference in the incidence of preterm delivery, preeclampsia, placental abruption, malpresentation, cervical incompetence, first trimester bleeding, and miscarriage when compared with previously reported data. Pregnancy outcomes among patients with a history of cervical dilation and those without were not significantly different.

The current study suggests that dilation and curettage may predispose to postpartum hemorrhage. It is important to consider the effects of surgical management for miscarriage on future pregnancy outcomes.