What is Dilation and Curettage (D&C)?

Dilation and Curettage (D&C) is a procedure that involves dilation of the cervix and insertion of a curette, a specialized instrument, to remove tissue from the uterus (womb).

Why is a D&C Performed?

You may be recommended to undergo a D&C for the diagnosis and treatment of uterine problems such as abnormal vaginal bleeding, uterine fibroids, uterine cancer, polyps, etc. It can also be performed to remove the products of conception following a miscarriage or abortion.

Preparation for the Procedure

Talk to your doctor about the medicines you are taking and those you should stop taking prior to the procedure. Inform your doctor if you are allergic to any medicines or anesthesia.

D&C Procedure

The D&C procedure is usually performed along with a hysteroscopy. A hysteroscope is a thin instrument with a light and camera which is inserted through the vagina to get a magnified view of your uterus.

The steps involved in a D&C procedure include:

You may be given a general, spinal or local anesthesia.
You will lie on a table on your back with your heels in stirrups.
Your doctor will gently insert a speculum into your vagina and use clamps to hold your cervix in place.
Your cervix is then cleaned with an antiseptic solution and medicine is used to soften your cervix followed by insertion of dilation rods.
A curette (spoon-shaped instrument) is inserted and scraping of the uterine tissue is performed to remove any abnormal uterine tissue.
A cannula may be used to suction the scraped tissue.
A sample of your uterine tissue may be sent to the laboratory for detailed examination.

After the Procedure

You will need to spend some time in the recovery room under observation. Your doctor will discuss the results of your procedure either on the same day after your procedure or during your follow-up. You may be prescribed medication to relieve your pain.

First few days after the procedure:

You may experience mild cramping, nausea or vomiting
Light-spotting may occur
Avoid sex and use of tampons per your doctor's instructions
Your next period can be delayed as it takes some time for the formation of your uterine lining.

Contact your doctor if you experience any of the following:

Pain getting worse
Heavy bleeding
Fever
Foul smelling vaginal discharge
Cramps lasting more than 2 days

Complications of D&C

Serious complications are rare. Possible complications include:

Infections: Bacterial infections are common. Talk to your doctor about the possible ways to prevent infection after the procedure.
Perforation of the Uterus: This may occur accidentally. Most perforations heal naturally.
Formation of Scar Tissue: Scar tissue may develop in the uterus if a D&C is performed immediately after a miscarriage or delivery. Scar tissue formation is also known as Asherman’s syndrome. If left untreated, Asherman’s syndrome further leads to infertility.

Advantages of D&C

The benefits of a D&C procedure include:

Does not involve cuts or stitches
Minimizes the risk of certain uterine disorders
Clears any tissue remaining in your uterus after pregnancy
Does not affect future pregnancies
Helps diagnose cervical cancer

Contradictions of D&C

You may not be an ideal candidate for D&C if you are suspecting pregnancy, taking blood thinners, allergic to certain medications or have a history of bleeding disorders.