Dilation and Curettage (D&C): Procedure, Risks & Benefits

Dilation and curettage, also known as D&C procedure, is a brief surgical procedure to remove tissue from a woman’s uterus. A woman may need a D&C test if she has suffered a miscarriage, has leftover tissue after an abortion or experienced unexplained bleeding during periods.

In this article, we will understand in detail the DnC meaning, the procedure, risks, benefits and prevention.

What is Dilation & Curettage (D&C)?

Dilation and curettage is a brief surgical procedure done to remove tissue from a woman’s uterus. The D&C procedure involves the following:

1. Dilation of the cervix

The doctor will dilate or open your cervix, which is the opening of your uterus. Usually, the cervix only dilates before childbirth.

2. Curette

The doctor using a thin instrument scrapes the uterine wall to remove tissue.

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Procedure Details of Dilation & Curettage

Before beginning the D&C procedure, the doctor will give a medicine to help make you comfortable. You may be given general anesthesia so that you remain asleep for the procedure or you may be sedated but remain awake during the procedure.

During the D&C procedure, you will lie on a table with your feet in stirrups and:

1. Insert a speculum inside your vagina to help open up your cervix.

2. Use a clamp to hold the cervix in place.

3. Ensure that the cervix is dilated enough, using a series of rods to open it gradually.

4. Use a curette, a thin suction or scraping device, to clean out the tissue from your uterus.

Uterine curettage usually takes about ten minutes but the overall process may be longer. You will need to wait for a few hours after DnC treatment before you can go home.

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Risks of Dilation & Curettage

Although D&C procedure is safe and routine, it may have some risks like any other surgery. The risks of D&C procedure include the following:

1. Uterine perforation or a small tear in the uterus which can happen if the tip of the curette passes through the uterine wall

2. Uterine infection

3. Uterine bleeding

In the rarest of cases, a woman may develop Asherman’s syndrome if she has a D&C after a miscarriage. Asherman’s syndrome occurs when adhesions or scar tissues form in the uterus and begin to build up between the uterine walls. This causes the uterine walls to stick together, which may lead to infertility and changes in menstrual flow. However, doctors treat adhesions with surgery in most cases.

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Benefits of Dilation & Curettage

A DnC treatment has the following benefits:

1. Helps remove any leftover tissues from the uterus after a miscarriage or abortion

2. Helps prevent heavy bleeding and infection that may arise from any leftover tissues

3. Helps identify the reason behind abnormal bleeding

4. Helps to detect abnormal endometrial cells, which may be a symptom of uterine cancer

5. Helps remove any tumor that may form instead of a typical pregnancy (molar pregnancy)

6. Helps treat excessive bleeding after childbirth by clearing out placenta remains from the uterus

7. Helps remove cervical or uterine polyps, which are mostly noncancerous

How to Prevent Dilation & Curettage?

Dilation and curettage is only performed in specific cases such as abortion or miscarriage. You may be able to prevent the D&C procedure in case you get an early abortion using a pill. But only a doctor can help determine which is the best course of treatment for you.

When to See a Doctor

You must contact your doctor if you experience any of the following after a D&C procedure:

1. Heavy bleeding requiring you to change pads every hour

2. Dizziness or lightheadedness that lasts

3. Fever

4. Cramps for more than 48 hours

5. Worsening pain

6. Foul-smelling vaginal discharge

Closing Thoughts

Dilation and curettage is a brief and safe procedure carried out to remove tissues from the uterus. After the D&C procedure, your uterus will build a new lining which may cause your period to be early or late. If you had a D&C after a miscarriage and want to become pregnant, you must ask your doctor when it’s safe to try again.

References

1. Lohmann-Bigelow J, Longo SA, Jiang X, Robichaux AG 3rd. (2007). Does dilation and curettage affect future pregnancy outcomes? Ochsner J.

2. Cooper DB, Menefee GW.(2022). Dilation and Curettage.