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ERPC (Evacuation of Retained Products of Conception)

If you are considering having an ERPC or have one planned, it is important to know all you can about it. This includes:


  • why you need this operation

  • what it will be like

  • how it will affect you

  • what risks are involved

  • any alternatives.


The information here is a guide to common medical practice. Each hospital and doctor will have slightly different ways of doing things, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your treatment choices with your doctors. You should mention any worries you have. Remember that you can ask for more information at any time.



What is the problem?

You have had a miscarriage but there are still some tissues left in your uterus. This is usually mostly the remains of the placenta. Bleeding continues until you pass this from your body or we operate to remove it. The remains also give a risk of infection in your uterus.


What happens in early pregnancy?

Your womb, also called your uterus, is where a fertilised egg should develop into a baby. The lining of your uterus is called the endometrium. Each month your endometrium prepares for pregnancy by thickening as part of your monthly cycle. When your egg is fertilised by a sperm, the resulting pregnancy lodges in the prepared endometrium. The covering of the egg grows blood vessels into the wall of your uterus. Your blood vessels mingle with those from the developing baby. This develops into the early placenta. The baby at this early stage is called an embryo. After eight weeks of development it is called a fetus.



What has gone wrong?

Many miscarriages happen because the embryo fails to grow in the early days of pregnancy. This is often before the mother realises she is pregnant. The placenta, however, continues to grow for a short time, giving all the signs of pregnancy. Eventually the placenta fails and the uterus contracts to expel the tissues. This can cause bleeding and pain. Sometimes, some tissues stay inside the uterus causing heavy bleeding and the risk of infection.


The aims

This small operation will make sure that you have no pregnancy tissues left in your uterus. It will stop your bleeding and reduce your risk of infection. The operation is called an ‘evacuation’ and the tissues left in your uterus are called ‘products of conception’. The full name of this operation is therefore ‘evacuation of retained products of conception’ or ERPC for short.


The benefits

Your uterus should return to normal within a few weeks. Your bleeding will stop and you will be less at risk of infection.


What if you do nothing?

Without an operation, your uterus will either discharge the pregnancy tissues or absorb them, but this could take many weeks. During this time there can be serious bleeding or infection, which may rarely be life threatening.


Are there any alternatives?

Medication can be given to speed up your body’s natural processes. You will either discharge or absorb the tissues and you are likely to have some bleeding and pain during this time. Medication can be very effective but the time it takes varies. It is not always effective so you may still need a surgical evacuation. This is a good option if you are prepared to accept the uncertainty.


Author: Dr David Hutchon F.R.C.O.G. Consultant Gynaecologist.

© Dumas Ltd 2006

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