D&C much more than abortion!

Often times, women are told to plan their families appropriately and refrain from resorting to abortion as a family planning option. Rather than have an unplanned pregnancy, experts advise use of contraceptive devices and condoms because of the untoward effects abortion could have on a woman.

Unlike family planning methods, experts warn that when women resort to abortion with a common gynecological surgical procedure, known as dilatation and curettage (commonly called D&C), it could be a reason for them in future to have premature babies.

In a new study, experts found that women who have undergone dilation and curettage who later become pregnant may be at increased risk of giving birth before the baby reaches full term.

They end up with premature babies because of damage to the cervix, the opening at the bottom of the womb that normally stays closed during pregnancy but opens during labour.

In understanding more the risks of D&Cs, the scientists analysed 21 previously published studies that included more than two million women.

They found that compared with women who had never had a D&C, women who had undergone the procedure prior to giving birth were 29 per cent more likely to deliver their babies before the 37th week of pregnancy. Pregnancies are generally considered to reach full term at 37 weeks.

Also, women who had not undergone a D&C had a six per cent chance of having a preterm delivery, compared with 7.6 per cent for those who had undergone the procedure.

In addition, the procedure also increased women’s risk of preterm births, or those occurring before 32 weeks of gestation, by 69 per cent. The risks were higher for women who had multiple D&Cs.

According to the World Health Organisation, about 15 million babies are born before 37 weeks of gestation and complications arising from premature birth kill one million children a year worldwide. This makes it the leading cause of death for children under the age of five.

Professor Dapo Olayemi, a consultant obstetrics and gynecologist, however, linked the increase in possibility of women who have undergone dilation and curettage in their future pregnancies giving birth before the baby reaches full term to cervical incompetency.

He declared: “The weakening of the mouth of the womb of a woman makes her unable to carry a pregnancy to term. As a result of the neck of the mouth of the womb been loose, when pregnancy comes to put pressure on it, it opens up.”

“Also a complication of D&C is the puncture, adhesion or scarring of the walls of the womb.” When the linings of the womb stick together, this usually leads to infertility and may be a reason for the womb repeatedly aborting any implanted baby. These abortions take place early after conception,” he added.

Professor Olayemi, who assured that improvement in the conventional way D&C is done had made it far safer than before, stated that the use of D&C exceeds abortion purposes as many presume.

Sometimes a D&C is medically necessary. If a woman has unusually heavy bleeding as a miscarriage complication, a D&C can even be lifesaving because it stops the bleeding at the source.

In other cases, a D&C might be used if the doctor feels the miscarriage is unlikely to complete without intervention. In other cases, some women request a D&C because they prefer to get over the miscarriage rather than waiting for it to begin naturally.

A D&C may also make it easier to collect a usable tissue sample for couples who want to pursue chromosomal test on the baby.

D&C is one of the most common surgical procedures performed for abortion and miscarriage. During the 15-minute procedure, doctors dilate, or open, the cervix, then scrape the wall of the womb using either an implement called a curette or a vacuum suction tube.

Professor Olayemi, however, declared that many things aside miscarriage and abortion can predispose a woman to premature births, including infections, genetic problems and birth defects.

Common causes of preterm birth include multiple pregnancies, infections, bleeding in pregnancy, and chronic conditions, such as diabetes and high blood pressure; however, often no cause is identified. There is also a genetic influence.

Also, women with certain abnormalities of the reproductive organs are at greater risk for preterm labour and birth than are women who do not have these abnormalities.

 More than 60 per cent of preterm births occur in Africa and South Asia, but preterm birth is truly a global problem. In the lower-income countries, on average, 12 per cent of babies are born too early compared with nine per cent in higher-income countries. Within countries, poorer families are at higher risk. Babies born prematurely have reduced chances of survival and even when they survive, they are forced to contend with life-long ailments and conditions.
Source: tribuneonlineng

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