Miscarriage Cause
The emotional ramifications of miscarriage are significant but the physical ones are also of great importance. Understanding the reason for recurrent miscarriage is often key to treatment.
There are Guidelines for the management options for miscarriage which should be discussed. This should not be a briefly discussion. The management options chosen have an impact on future fertility and risk of miscarriage.
Often boxes are checked for leaflets to be given on Surgical Management + MVA, Medical Management at home and Natural Management. It is important to obtain those leaflets but they may not reveal the true risks. 
Often during interview patients are offered “taking tablets or surgery”. There is an emphasis on the slow possibly unsuccessful tablets whereas surgery means a quick resolution to the miscarriage but without considering the future. Some women are told that medical management is unlikely going to be successful and that it would be better to have surgery as it is almost inevitable that surgery will be needed.
D&C and its connection to Asherman’s
The main complication of surgery is uterine perforation but many are not told about the risks of developing intrauterine adhesions and its consequences. They are not told what adhesions are and their likely impact on future pregnancy. Some hospitals state that it is a known complication of the procedure with a prevalence of about 20% but usually without any effect on fertility. This is not true. The prevalence is a 25% risk of developing Asherman’s syndrome following a D&C performed 2-4 weeks after delivery, and 30.9% risk of developing Asherman’s syndrome from D&C following a miscarriage.
Adhesions following surgery are caused by the trauma to the lining from a D&C (dilation and curettage).
A recently pregnant uterus is much more susceptible to developing Asherman’s after D&C compared to a non-pregnant uterus. Having multiple D&Cs increases the risk for developing scar tissue in the uterus.
What does it mean for fertility?
Scar tissue forms inside the uterus and/or the cervix and can result in infertility, recurrent miscarriage, and high-risk pregnancies. Thus recurrent surgery for miscarriage perpetuates the adhesions.
Therefore if you are experiencing miscarriage and have had a D&C it is important to have a scan to determine if there are adhesions which may be causing the same.
Many women feel that they would have chosen no treatment (and let nature take it’s course) or medical over surgical treatment had they been aware of the risk of developing Asherman’s syndrome.
Call us today
If you’re ready to discuss your situation or have any questions please contact Dr Victoria Handley today. Don’t suffer in silence. Call FREE on 0800 470 2009 or email vhandley@handleylaw.co.uk