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What is D&C ?

Dilation and curettage (D&C) is a surgical procedure performed on the uterus to remove the endometrium (lining of the womb) by dilating the cervix, which is the neck of the uterus.

INDICATIONS:

A D&C can be either diagnostic or therapeutic in nature. Diagnostic D&C is done toobtain sample of the endometrial tissue in cases of :

1. Abnormal uterine bleeding
2. Suspicious endometrial cells in a routine pap smear.
3. Post menopausal bleeding

D&C can also be uterus cleaning treatment in some conditions such as :

• Following an incomplete abortion to remove the remaining tissues, sothat no infection or excessive bleeding develops
• It can also be used after childbirth to clear out minor pieces of the placenta,which remains attached to the endometrium causing severe bleeding.
• To resolve abnormal uterine bleeding from irregular to very heavy menstrual flow

Pre-Procedure:

D&C procedure is done under anesthesia .The type of anesthesia chosen will depend on the patient’s medical history and also the indication for the D&C. Pre operative fasting may be needed as advised by the doctor .The doctor may also prescribe some medications to start cervical dilatation.

D&C Procedure

• Under anesthesia, the size and position of the uterus is examined.
• An instrument called speculum is inserted into the vagina to hold the walls apart.
• The entrance of the cervix is widened using dilators which vary in size,
• Curette, which is a spoon-shaped instrument, is inserted into the uterus through the dilated cervix.
• Endometrium, that is the lining of the uterus, is scraped off by the curette.
• The collected tissues are then sent to a laboratory for further examination.

Following the procedure, the patient is shifted to the recovery room where she is closely monitored for vaginal bleeding.
In uncomplicated cases the patient is discharged after 6 hours.

Complications

D&C is generally considered a safe procedure but as with all surgeries there may be unexpected complications such as

• Heavy bleeding
• Allergic reactions to medications used
• Infection
• Cervical damage due to passage of instruments
• Puncture of the uterus
• Uterine endometrial scarring

Recovery

Recovery may vary depending on each individual and the form of anesthesia used. Most individuals may experience cramps or slight vaginal spotting after D&C Proper rest and nutrition is advised. In case of heavy bleeding, chills, fever or foul smelling drainage from the vagina make sure to consult your doctor.