Should You Stop Aspirin Before Uterine D&C Surgery?

Should aspirin be discontinued before a hysteroscopy?

Hello, Director Lin: Recently, my doctor informed me that I have endometrial hyperplasia and a small polyp (1 small one).
The doctor said I need to undergo a dilation and curettage (D&C) procedure to remove tissue for cancer testing.
I have been taking aspirin long-term; should I stop this medication before the surgery? If so, how many days in advance should I stop? Additionally, I have new vascular disease; what type of anesthesia and anesthetic would be safer for me? Thank you very much for answering my questions!

Nìmíng, 40~49 year old female. Ask Date: 2018/09/23

Dr. Lin Xiuying reply Anesthesiology

Hello, in general, surgeries will avoid complications from bleeding due to coagulation disorders.
Therefore, patients taking aspirin or those who are expected to have significant blood loss during surgery should discontinue the medication 5-7 days prior.
However, regarding the typical blood loss during a dilation and curettage (D&C) procedure and whether there is a need to stop medication, it would be best to consult your obstetrician-gynecologist, as they may have different recommendations.

Typically, a D&C is performed under intravenous general anesthesia (prescribed and determined by the anesthesiologist), and the surgery duration is usually not long (generally within ten to fifteen minutes).
Both the procedure and the anesthesia method have a high safety profile! Of course, compared to healthy individuals, patients with cardiovascular diseases may have a higher risk during anesthesia.
However, there is no need to worry too much; following the necessary protocols (such as preoperative anesthesia assessment, etc.) and being cared for by qualified anesthesia professionals, patients should be able to recover safely.
Wishing you a successful surgery!

Reply Date: 2018/09/23

More Info

When preparing for a uterine dilation and curettage (D&C) surgery, it is important to consider the medications you are currently taking, particularly anticoagulants like aspirin. Aspirin is known for its blood-thinning properties, which can increase the risk of bleeding during and after surgical procedures. Therefore, it is generally recommended to stop taking aspirin prior to surgery.

In your case, since you have been diagnosed with endometrial hyperplasia and a polyp, and you are scheduled for a D&C to evaluate for potential cancer, it is advisable to discontinue aspirin use. The typical recommendation is to stop taking aspirin about 2 to 3 days before the surgery. This timeframe allows your body to clear the medication from your system, thereby reducing the risk of excessive bleeding during the procedure. However, it is crucial to consult with your healthcare provider for personalized advice, as they will consider your specific medical history and the details of your surgery.

Regarding your question about anesthesia, the choice of anesthetic agents and techniques will depend on several factors, including your overall health, the presence of any comorbid conditions (such as your vascular disease), and the complexity of the procedure. Generally, D&C procedures can be performed under local anesthesia, sedation, or general anesthesia.
For patients with vascular diseases, regional anesthesia (such as a spinal or epidural block) may be considered, as it can provide effective pain relief while minimizing the risks associated with general anesthesia. However, the final decision should be made by your anesthesiologist, who will evaluate your medical history, current medications, and any potential risks associated with anesthesia.

It is also important to inform your healthcare team about all medications you are taking, including any over-the-counter drugs, supplements, or herbal remedies, as these can interact with anesthesia and other medications used during surgery.
In summary, it is advisable to stop taking aspirin 2 to 3 days before your D&C surgery to minimize bleeding risks. Additionally, the choice of anesthesia should be discussed with your healthcare provider and anesthesiologist to ensure the safest and most effective approach for your specific situation. Always follow the guidance of your medical team, as they are best equipped to make recommendations based on your individual health needs.

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