D & C Procedures May Raise Risk of Preterm Birth: Study

Researcher suggests more caution for women's surgical procedure for certain patients

By Robert Preidt

Wednesday, June 17, 2015

WEDNESDAY, June 17, 2015 (HealthDay News) -- A widely used gynecological procedure may increase the risk of preterm delivery in future pregnancies, a new study suggests.

Dilation and curettage (D&C) is one of the most common minor surgeries in obstetrics and gynecology. It is used in cases of miscarriage and abortion, among other reasons.

While generally considered safe, previous research has found that D&C is associated with some rare but serious side effects, including tears or punctures in the cervix or uterus, infection and bleeding.

In this new study, researchers reviewed 21 studies that included nearly 2 million women. It found that D&C performed in cases of miscarriage or abortion was associated with a 29 percent increased risk of preterm birth (less than 37 weeks) in a later pregnancy, and a 69 percent increased risk of very preterm birth (less than 32 weeks) in a later pregnancy.

Although this study found an association between D&C and preterm birth, it cannot prove a cause-and-effect relationship.

Typical risk for preterm delivery is about 6 percent, while having an earlier D&C appears to increase the risk to almost 8 percent, according to the researchers. That nearly 2 percent higher risk translates to about 16 extra preterm births per 1,000 women who have undergone D&C, the review found.

The results suggest the need for caution in the use of D&C in cases of miscarriage and abortion. The results also lend further support for the use of less invasive procedures in such cases, according to study author Dr. Pim Ankum, a gynecologist at the Academic Medical Center, University of Amsterdam, the Netherlands.

The study was to be presented Tuesday at a European Society of Human Reproduction and Embryology meeting in Lisbon, Portugal. Results from studies presented at meetings are generally viewed as preliminary until they've been published in a peer-reviewed journal.

SOURCE: European Society of Human Reproduction and Embryology, news release, June 16, 2015

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