The Intraoperative Complication Rate of Nonobstetric Dilation and Curettage

OBJECTIVE: To evaluate the intraoperative complication rate of nonobstetric dilation and curettage (D&C) in a large series of consecutive patients. METHODS: In this retrospective study, 5,359 nonobstetric D&Cs performed in 2,542 premenopausal and 2,817 postmenopausal patients between October 1995 and December 2006 were evaluated. Intraoperative procedure-associated complication rate and identification of risk factors for the occurrence of complications were the main outcome measures. Univariable and multivariable analyses were performed. RESULTS: A total of 103 (1.9%) intraoperative complications were noted. Uterine perforation occurred in 50 cases (0.9%) (perforation site: fundus, n=47; cervix, n=3). Forty-two (0.8%) cases of false passage, seven cases (0.1%) with severe hemorrhage, three cases of vaginal laceration, and one case of cervical laceration were noted. In a multivariable analysis, retroversion of the uterus (P=.008), postmenopausal status (P=.003), and nulliparity (P=.03) were significantly associated with occurrence of intraoperative complications. CONCLUSION: The overall complication rate of D&C is low. A retroverted uterus, postmenopausal status, and nulliparity are independent risk factors for intraoperative complications. (Obstet Gynecol 2009;113:1268-71)