D&C—Dilation and Curettage

Dilation and curettage or D&C is used to remove tissue from the inside of the uterus as a way of treating certain conditions like heavy bleeding or to clear away the uterine lining following a miscarriage. During a D&C, your doctor will use medication to dilate the cervix or the lower part of the uterus then use surgical instruments to remove any necessary tissue. This can be done with sharp tools or suction depending on the condition of the tissue.

Why Is D&C Carried Out?

A D&C may be performed for a variety of reasons. It can be done to remove portions of the placenta after birth or to remove tissue from the uterus during an abortion or after a miscarriage, which prevents heavy bleeding or infection.

A D&C can also be used to diagnose or manage abnormal bleeding or to diagnose conditions such as a hormonal imbalance, polyps, fibroids, uterine cancer or endometriosis. Once those abnormal cells are harvested, they can be examined to determine the causes of any symptoms the patient is experiencing.

What Are the Procedures of D&C?

During a D&C, your doctor will start by inspecting the reproductive organs for any abnormalities. A speculum will be used to separate the vaginal walls to view the cervix easily, and then a clamp will be used to hold the cervix in an open position to provide access to the uterus. A curette will then insert into the uterus to gently scrape away the offending tissue. This will loosen portions of the uterine lining to be removed with a tube applying suction. The removed samples will then be sent to a lab to be examined under a microscope to determine what conditions might be present.

Your doctor may combine a D&C along with other procedures such as a hysteroscopy. During this procedure, an instrument equipped with a light and camera will insert into the vagina and cervix to view the lining of the uterus. If there are portions of the uterine lining that appear abnormal, the doctor will check for polyps, fibroids or other tissue. These can be removed as necessary during the procedure.

What to Do after D&C

What to Expect after a D&C

Following the surgery, the patient will be transferred to a post-anesthesia unit to recover from the procedure. Once you return home, it will be a few days before you can return to normal activity. If you are experiencing symptoms such as cramping or pain, you can use non-steroidal anti-inflammatory medication to manage your symptoms. You should avoid inserting anything into the vagina for two weeks after the procedure, including abstaining from sexual intercourse, which will assist to decrease your risk of infection.

The follow-up care after a D&C will vary. Most doctors will schedule a follow-up visit 2-6 weeks after the procedure. In that visit, your doctor needs to check your conditions and talk with you about the testing results of the tissue samples that have been removed during D&C. In some cases your doctor will simply make a phone call to inform you of the results of your testing.

How to Take Care of Yourself at Home

  • Try to Avoid Physical Activity

Most women feel capable of returning to normal activity a few days after their D&C, but women should not do any strenuous activity for at least 24 hours.

  • Take Some Medications

During this period, light bleeding or cramping are possible but can be managed with mediations such as ibuprofen.

  • Avoid Intercourse and Tampons

Do not use tampons in the next 2-6 weeks and do not have intercourse unless you get the permit from your doctor first.

Once you start having sex again, be aware that your ovulation cycle may be interrupted so you may need to talk to your doctor about what you need to do if you are trying to get pregnant again.

Possible Risks of D&C

Generally speaking, a D&C is quite safe, but all surgical procedures carry some risks.

  • The Damage of Cervix.

In D&C, the cervix might be damaged due to excessive pressure or tearing. Stitches or medication can be used to manage the bleeding if this occurs.

  • The Uterus Issues

The uterus could also suffer a perforation during the procedure, which is more common in women getting pregnant recently or women who have experienced menopause. If a blood vessel or other organs are damaged during a perforation, it will need to be repaired with a second procedure.There may also be scarring on the uterine wall, a condition known as Asherman’s syndrome, in rare cases.

  • Infection

In rare cases, the patient may experience an infection following a D&C. This is more likely if a D&C is performed after delivery or miscarriage and could lead to painful, abnormal or the absence of your menstrual cycle, infertility or future miscarriage.

When to Be Concerned

It is common to experience some discomfort after a D&C, but you should be aware of what symptoms could be the sign of a problem. Contact your doctor if you experience:

  • Bleeding for over 2 weeks
  • Dizziness or fainting
  • Cramping for over 2 weeks
  • Increased or severe pain
  • Bleeding that causes you to fill more than one pad an hour
  • Foul smelling discharge
  • Fever over100.4 °F
  • Chills

A mother shares her first experience of D&C that may help you have a better understanding of D&C: