Dilation and curettage

Dilation and Curettage (D&C) refers to a surgical process in which the cervix is dilated and the uterine lining is scraped using a special instrument.

Reasons for D&C Procedure

  • For removing the tissue in the uterus during or after an abortion or miscarriage
  • For removing small pieces of placenta following childbirth. This helps to prevent infection or severe bleeding
  • For diagnosing or treating abnormal uterine bleeding
  • For diagnosing or treating abnormal growths such as fibroids, polyps, endometriosis, hormonal imbalances, or uterine cancer.

What to Expect When Having a D&C

You can have a D&C either in the doctor’s office, a clinic, or hospital. This procedure generally takes only 10 to 15 minutes. However, you may be required to stay in the office, clinic, or hospital for up to five hours.

Prior to D&C, the doctor will evaluate your medical history and sign a consent form. You should inform the doctor if:

  • You are pregnant.
  • You are allergic to any particular medicines, iodine, or latex.
  • You have a medical history of bleeding disorders or if you have taken any blood-thinning drugs.
  • You will receive either general anesthesia or spinal or epidural anesthesia. The type of anesthesia depends on the procedure you require.
  • Before the procedure, you may be required to remove your clothes, wear a gown, and empty your bladder.

D&C Procedure

During D&C process, you will have to lie on your back and place your legs in stirrups. The doctor then inserts a speculum into your vagina and holds the cervix in position using a clamp.

A D&C procedure primarily involves two steps

  • Dilation refers to widening the opening of the cervix to facilitate the insertion of a special equipment. The doctor would insert ‘laminaria’, a thin rod, into the opening to gradually widen it. You may be even administered medication that will soften the cervix and help it to widen.
  • Curettage is a process that involves scraping the uterine lining and removing its contents using a curette, a long, spoon-shaped equipment. A cannula may be also used to suction the leftover contents from the uterus. A tissue sample is then sent to the lab for examination.
    Sometimes, certain other procedures such as hysteroscopy are performed along with a D&C.

Risks and side effects

  • Cramping
  • Slight bleeding
  • Certain complications such as a damaged cervix and perforated uterus or bowel are extremely rare. However, please do contact your doctor if you have any of these symptoms

Symptoms after D&C

  • Prolonged bleeding or blood clots
  • Fever
  • Pain
  • Tenderness in the abdomen
  • Foul-smelling vaginal discharge
    In certain cases, scar tissue may form within the uterus. Known as Asherman’s syndrome, this problem may result in infertility and sudden changes in menstrual flow. Surgery will surely help to repair this problem.

Recovery after a D&C

  • You can resume your daily activities within one or two days. You may also have slight cramping and spotting for some days. This is quite normal. So, always wear sanitary pad for spotting and take pain relievers to alleviate pain.
  •  The timing of your next menstrual period may change. It may be either early or late. In order to avoid bacteria from passing into your uterus, it is better to refrain from sex and use tampons for a while.
  •  Perform a follow-up visit to your doctor and schedule further treatment that is required.