Dilation and Curettage (D and C)

What is a dilation and curettage (D&C)?

(Dilatation and Curettage, D&C)

A dilation and curettage procedure, also called a D&C, is a surgical process in which the cervix (lower, narrow part of the uterus) is dilated (expanded) so that the uterine lining (endometrium) tin can be scraped with a curette (spoon-shaped instrument) to remove abnormal tissues.

Other related procedures used for diagnosing and treating the endometrium include endometrial ablation, hysteroscopy, and hysterectomy. Please see these procedures for boosted information.

Illustration of the anatomy of the female pelvic area

What are female person pelvic organs?

The organs and structures of the female pelvis are:

  • Endometrium . This is the lining of the uterus.

  • Uterus (also chosen the womb). The uterus is a hollow, pear-shaped organ located in a woman's lower abdomen, between the bladder and the rectum. The uterus sheds its lining each month during menstruum, unless a fertilized egg (ovum) becomes implanted and pregnancy follows.

  • Ovaries. 2 female reproductive organs located in the pelvis in which egg cells (ova) develop and are stored and where the female person sex hormones estrogen and progesterone are produced.

  • Neck. The lower, narrow part of the uterus located between the bladder and the rectum, forming a canal that opens into the vagina, which leads to the outside of the body.

  • Vagina (besides called the birth canal). The passageway through which fluid passes out of the body during menstrual periods. The vagina connects the cervix and the vulva (the external genitalia).

  • Vulva. The external portion of the female genital organs.

  • Fallopian tube. Two thin tubes that extend from each side of the uterus, toward the ovaries, as a passageway for eggs and sperm.

The menstrual cycle

With each menstrual cycle, the endometrium prepares itself to nourish a fetus, as increased levels of estrogen and progesterone help to thicken its walls. If implantation of the fertilized egg does not occur, the lining of the endometrium, coupled with blood and fungus from the vagina and cervix (the lower, narrow part of the uterus located betwixt the bladder and the rectum), make upward the menstrual menstruum (also chosen period) that leaves the trunk through the vagina. Afterwards menopause, period stops and a adult female should not have whatsoever bleeding.

Reasons for the process

A D&C may be used equally a diagnostic or therapeutic procedure for abnormal bleeding. A D&C may be performed to determine the crusade of aberrant or excessive uterine bleeding, to detect cancer, or equally part of infertility (inability to become pregnant) investigation.

Causes of abnormal haemorrhage include the presence of aberrant tissues, such as coarse tumors (beneficial tumors that develop in the uterus, also called myomas) polyps, or cancer of the endometrium or uterus. Tissues obtained from the D&C tin can be examined under a microscope. Abnormal uterine haemorrhage may also be due a hormone imbalance or disorder (particularly estrogen and progesterone) especially in women approaching menopause or subsequently menopause.

A suction D&C uses suction to remove uterine contents. A suction D&C may exist used post-obit a miscarriage to remove the fetus and other tissues if they have not all been naturally passed. Infection or heavy bleeding tin occur if these tissues are not completely removed.

Occasionally post-obit childbirth, minor pieces of the placenta (afterbirth) remain adhered to the endometrium and are non passed. This can cause haemorrhage or infection. A D&C may exist used to remove these fragments then that the endometrium tin heal properly.

At that place may be other reasons for your doctor to recommend a D&C.

Risks of the procedure

As with whatever surgical procedure, complications may occur. Some possible complications of a D&C may include, but are not express to, the following:

  • Heavy bleeding

  • Infection

  • Perforation of the uterine wall or bowel

  • Adhesions (scar tissue) may develop inside the uterus

Patients who are allergic to or sensitive to medications, iodine, or latex should notify their doctor.

If you lot are significant or suspect that you may be meaning, you should notify your wellness care provider.

There may be other risks depending on your specific medical condition. Exist sure to discuss any concerns with your doctor prior to the process.

A vaginal, cervical, or pelvic infection may interfere with a D&C.

Before the procedure

  • Your doctor will explain the procedure to yous and offer you the opportunity to ask whatsoever questions that you might have almost the procedure.

  • You will be asked to sign a consent grade that gives your permission to practice the process. Read the form carefully and ask questions if something is non clear.

  • In addition to a complete medical history, your doctor may perform a complete physical examination to ensure you are in good wellness before undergoing the procedure. You may undergo blood tests or other diagnostic tests.

  • If your procedure requires general, spinal, or epidural anesthesia, yous will be asked to fast for eight hours before the procedure, generally later on midnight. If your procedure is to be washed nether local anesthesia, your doctor volition give you lot instructions nigh fasting.

  • If yous are significant or suspect that you are pregnant, y'all should notify your health intendance provider. He or she may recommend a pregnancy exam prior to the process.

  • Notify your md if you lot are sensitive to or are allergic to any medications, iodine, latex, tape, and anesthetic agents (local and general).

  • Notify your doctor of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.

  • Notify your doctor if you lot accept a history of haemorrhage disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. Information technology may be necessary for you to terminate these medications prior to the procedure.

  • If a sedative is given before the procedure, you will need someone to drive you dwelling afterwards.

  • You may want to bring a germ-free napkin to wear home later on the procedure.

  • Based on your medical condition, your doctor may request other specific preparation.

Illustration of a dilation and curettage procedure

During the procedure

A D&C may be performed in a doctor'due south office, on an outpatient basis, or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor's practices.

The type of anesthesia will depend on the specific procedure being performed. Some D&C procedures may be performed while you are asleep under general anesthesia, or while yous are awake under spinal or epidural anesthesia. If spinal or epidural anesthesia is used, you will take no feeling from your waist down. The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and claret oxygen level during the surgery.

More often than not, a D&C follows this process:

  1. You lot will exist asked to remove article of clothing and be given a gown to habiliment.

  2. You will be instructed to empty your float.

  3. You will be positioned on an operating or test tabular array, with your feet and legs supported as for a pelvic exam.

  4. An intravenous (IV) line may be started in your arm or hand.

  5. A urinary catheter may exist inserted.

  6. Your md will insert an musical instrument chosen a speculum into your vagina to spread the walls of the vagina apart to betrayal the cervix.

  7. Your neck may be cleansed with an antiseptic solution.

  8. For local anesthesia, the physician may numb the area using a small needle to inject medication.

  9. If general or regional anesthesia is used, the anesthesiologist will continuously monitor your heart rate, blood pressure level, animate, and blood oxygen level during surgery.

  10. A type of forceps, called a tenaculum, may be used to concord the cervix steady for the procedure.

  11. The inside of the cervical canal may exist scraped with a modest curette if the cervical tissue needs to be examined.

  12. A thin, rod-like instrument, called a uterine sound, may exist inserted through the cervical opening to determine the length of the uterus. If you have local anesthesia, this may crusade some cramping. The sound will and so exist removed.

  13. The cervix will exist dilated by inserting a series of thin rods. Each rod volition be larger in diameter than the previous 1. This process volition gradually enlarge the opening of the cervix so that the curette (spoon-shaped instrument) can exist inserted.

  14. The curette will be inserted through the cervical opening into the uterus and the sharp spoon-shaped edges will be passed across the lining of the uterus to scrape away the tissues. In some cases, suction may be used to remove tissues. If you lot take local anesthesia, this may crusade cramping.

  15. The instruments will be removed.

  16. Whatever tissues collected with the procedure will be sent to the lab for test. Pregnancy tissues (called products of conception) may exist sent to the lab for culture or testing for genetic or chromosomal abnormalities.

After the procedure

The recovery process will vary depending on the blazon of procedure performed and type of anesthesia that was administered.

If you received regional or general anesthesia, you will be taken to the recovery room for ascertainment. One time your blood force per unit area, pulse, and breathing are stable and yous are alert, you will be taken to your hospital room or discharged to your home. If this process was performed on an outpatient basis, you should programme to take another person drive you domicile.

After a D&C using local anesthesia, y'all may balance for about two hours before going home.

You may want to wear a sanitary pad for haemorrhage. Information technology is normal to have some spotting or light vaginal haemorrhage for a few days after the procedure.

You may experience cramping for the first few days later on a D&C.

You may be instructed not to douche, use tampons, or have intercourse for two to three days after a D&C, or for a period of time recommended by your doctor.

Y'all may besides have other restrictions on your activity, including no strenuous action or heavy lifting.

Because a D&C removes the lining of the uterus, the lining must build back up. Your next menstrual period may begin earlier or after than usual.

You lot may resume your normal diet unless your doctor advises you differently.

Have a pain reliever for cramping or soreness as recommended by your medico. Aspirin or certain other pain medications may increase the take chances of bleeding. Be certain to accept only recommended medications.

Your md will advise you on when to return for further handling or intendance.

Notify your doctor if you have any of the following:

  • Heavy bleeding

  • Foul-smelling drainage from your vagina

  • Fever and/or chills

  • Astringent abdominal pain

Your dr. may requite you additional or alternate instructions subsequently the procedure, depending on your detail situation.

Online resource

The content provided here is for advisory purposes simply, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical communication y'all receive from your doc. Please consult your health intendance provider with whatsoever questions or concerns you may have regarding your condition.

This page contains links to other websites with information about this procedure and related health conditions. We promise you find these sites helpful, only please remember we exercise not command or endorse the data presented on these websites, nor do these sites endorse the information contained here.

American Cancer Society

American College of Obstetricians and Gynecologists

American Social club for Reproductive Medicine

National Cancer Institute (NCI)

National Institutes of Health (NIH)

National Library of Medicine

National Women's Health Information Centre