What should I do if I continue to bleed after a diagnostic curettage?

If you experience persistent vaginal bleeding after a diagnostic dilation and curettage (D&C), it is important to seek prompt medical evaluation. While light spotting for up to 7–10 days post-procedure is common, ongoing or heavy bleeding—especially if accompanied by clots larger than a quarter, soaking through more than one pad per hour, fever (>38°C), severe pelvic pain, or foul-smelling discharge—may indicate complications such as incomplete tissue removal, uterine perforation, infection (endometritis), or coagulopathy.

Your healthcare provider will likely perform a pelvic examination, assess vital signs, and may order transvaginal ultrasound to evaluate for retained products of conception or structural abnormalities. Additional testing could include a complete blood count (CBC) to check for anemia or infection, C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) if infection is suspected, and beta-hCG if pregnancy-related tissue is a concern. In cases of confirmed retained tissue, repeat D&C or medical management with misoprostol may be considered. Antibiotics are indicated for clinical signs of infection, and supportive care—including iron supplementation for iron-deficiency anemia—may be necessary.

It is essential not to delay evaluation, as untreated complications can lead to significant morbidity, including sepsis or hemorrhagic shock. Follow-up should occur within 1–2 weeks post-procedure, or sooner if symptoms worsen. Avoid sexual intercourse, tampon use, and douching until cleared by your clinician to reduce infection risk and support endometrial healing.