Dilation and Curettage

(D&C)
  • Definition

    Dilation is a procedure to open and widen the cervix. The cervix is the entrance to the uterus. Curettage is the removal of the lining of the uterus by scraping. The lining is known as the endometrium. The two procedures are done together and are often referred to as a D&C.
    Dilation and Curettage
    dilation and curretage
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  • Reasons for Procedure

    A D&C is usually done to determine what condition is causing abnormal bleeding. Some conditions that may cause abnormal bleeding are:
    Sometimes a D&C is done to stop the bleeding, rather than to diagnose why you are bleeding. For example, this procedure may be done to remove products of conception or to treat bleeding that has not responded to other methods.
    A D&C is not done if you have an infection, such as one that affects the uterus or fallopian tubes.
  • Possible Complications

    Complications are rare. But no procedure is completely free of risk. If you are planning to have a D&C, your doctor will review a list of possible complications, such as:
    • Complications related to anesthesia
    • Injury to the cervix
    • Scarring of endometrium
    • Infection of the uterus or fallopian tubes
    • Uterine perforation (hole in the uterus)
    • Bleeding
    • Damage to other organs in the abdomen
    • Need for additional surgery
    • Possible need to remove the uterus ( hysterectomy )
    Factors that may increase the risk of complications include having a pre-existing infection or condition.
  • What to Expect

    Prior to Procedure
    Talk to your doctor about all the medications you are taking. Up to one week before the surgery, you may be asked to stop taking some medications.
    In addition, arrange for a ride home and for help at home.
    Anesthesia
    General or local anesthesia may be used.
    • General anesthesia—keeps you asleep throughout the surgery
    • Local anesthesia—numbs the area only
    Description of Procedure
    A pelvic exam will be done to find out the size and location of the uterus. The vagina and cervix will be cleaned with an antiseptic solution. A speculum will be placed in the vagina. An instrument called a cervical dilator will be placed into the cervical canal. Once the cervical canal is slightly open, a scoop-shaped instrument, called a curette, will be inserted into the uterus. It will be used to scrape the uterine lining and remove tissue through the vagina. After sampling the endometrium, the instrument will be removed from the cervix.
    Immediately After Procedure
    You will be taken to a recovery room, where the nurses will monitor you.
    How Long Will It Take?
    You may be able to go home in a few hours.
    Will It Hurt?
    If you have general anesthesia, you will have no pain during the procedure. With local anesthesia, you may have some cramping and back pain.
    After the procedure, pain may last up to 24 hours.
    Post-procedure Care
    At the Care Center
    You will be monitored in the recovery center.
    At Home
    When you return home, do the following to help ensure a smooth recovery:
    • It is common to have some vaginal bleeding and discharge after a D&C. Use sanitary pads, not tampons.
    • Refrain from placing anything inside your vagina until instructed by your doctor. The cervix has been opened. This may make it easier for you to get an infection in the uterus.
    • Be sure to follow your doctor's instructions.
    Your next menstrual cycle may not be regular. It may be late or early.
  • Call Your Doctor

    After arriving home, contact your doctor if any of the following occur:
    • Signs of infection, including fever and chills, increasing pain, or foul-smelling vaginal discharge
    • Nausea or vomiting that does not stop
    • Abdominal pain
    • Vaginal bleeding that is saturating more than one sanitary pad per hour
    • Cough, shortness of breath, or chest pain
    If you think you have an emergency, call for emergency medical services right away.
  • RESOURCES

    The American Congress of Obstetricians and Gynecologists http://www.acog.org

    Women's Health—US Department of Health and Human Services http://www.womenshealth.gov

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

    Women's Health Matters http://www.womenshealthmatters.ca

    References

    D&C procedure after a miscarriage. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancycomplications/dandc.html. Updated November 2011. Accessed October 30, 2014.

    Dilation and curettage. The American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq062.pdf?dmc=1&ts=20120813T1113192776. Published May 2012. Accessed October 30, 2014.

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