Question:
Dear Doctor Ramirez, I’m 35 with two beautiful kids. On 2/6/13, I underwent a D&C, dilatation and curettage, (approx. 8wks in-missed miscarriage). Bled on and off for two weeks. Approx. 3 days after the bleeding stopped, AF (menstrual cycle) came for 5 days. I’m now TTC (trying to conceive), but I am now having mid cycle bleeding. So far I have bled for 3 days. I am at a loss. Can mid-cycle bleeding keep me from getting pregnant? Or is this just a sign of something else? Should I go see my obgyn?
Thank you. A. from California
Answer:
Hello A. from the U.S. (California),
The bleeding you are having is abnormal and could prevent pregnancy. Blood is toxic to an embryo. It could also indicate that there might be some “retained” placental tissue that was missed at the D&C. That would be my number one suspicion since you bled for so long after the D&C. The bleeding should only have lasted a day or two. I would advise that you see your gynecologist. They need to evaluate for retained products of conception.
One serious complication from a poorly done D&C is “Asherman’s Syndrome”. The placenta may have attached very deeply in the endometrium or fibrotic activity of retained products of conception could have occurred both of which make it difficult to remove retained tissue without causing injury to the basal endometrium. Asherman’s Syndrome is characterized by the formation of adhesions (scar tissue) inside the uterus. This syndrome occurs when trauma to the endometrial lining triggers the normal wound-healing process, which causes the damaged areas to fuse together. Some describe this scar formation as a very tough tissue that acts like “super glue” in the uterine cavity. To make the diagnosis of Asherman’s syndrome, you need to have a procedure called a hysteroscopy.
Good luck and don’t waste any time making an appointment!
Dr. Edward J. Ramirez, M.D. F.A.C.O.G.
