A dilation and curettage, often referred to as a D&C, is a surgical procedure that’s used for diagnosis of or therapy for abnormal or excessive bleeding of the uterus. A D&C is also performed to detect cancer or to help determine why a woman is infertile. There are a variety of reasons why a uterus may bleed, such as abnormal tissues, fibroid tumors, polyps, a hormone imbalance or cancer.
A D&C may be used after a miscarriage to remove the fetus or other tissues that have not been naturally passed through the vagina. Also, sometimes after childbirth, small pieces of placenta remain. It is critical that these tissues be removed. If not, infection or heavy bleeding can occur.
Things to Consider
Before scheduling a D&C, your physician will ask about your personal health, such as if you have any allergies or believe you could be pregnant. If your gynecologist determines that you should have a D&C, they will give you information on what you need to do to prepare, such as refraining from vaginal sex the day before the procedure. Also, if you are having an outpatient D&C, you will need to make sure someone is available to drive you home.
About the Procedure
A D&C may be performed at your gynecologist’s office, during a hospital stay or on an outpatient basis. Some D&C procedures are best performed under general anesthesia, while other times a spinal or epidural anesthesia may be recommended. With general anesthesia you are asleep, but with spinal or epidural, you are awake, but feel no pain.
During the procedure, the cervix is dilated so the lining of the uterus can be scraped to examine it at a lab or to remove any abnormal tissues. Typically, your gynecologist will follow these steps after opening the vagina and preparing it:
- An instrument called a uterine sound will be inserted into your cervix to determine its length.
- Your gynecologist will dilate your cervix by inserting a series of rods that are increasingly wider than the previous one. This enlarges the cervix opening so a spoon-shaped instrument called a curette can be inserted.
- The curette will pass across the lining of the uterus to scrape the tissues that need to be removed. In some cases, suction may be used to remove tissues.
- After this, the tools are removed and the procedure is complete.
After the Procedure
Afterwards, you will go to a recovery room where a clinician will monitor your vital signs. Once you are alert and stable, depending on your procedure, you will go to a hospital room or back home.
Once home, you may experience cramping for several days. You should not engage in any strenuous activity or heavy lifting in the first few weeks after the procedure. Your gynecologist will give you more information about self-care at home and what to expect.