What is Dilatation and Curettage (D&C)?

Dilation and curettage (D&C) is a surgical procedure used to remove tissue and other material from the uterus. It is a minor surgery, and most patients can go home the same day.

D&C can be performed for diagnostic reasons or as part of a treatment plan. D&C causes can include an endometrial biopsy or clearing the uterus after a miscarriage.

If your gynaecologist at Max Hospital has recommended a D&C procedure, you may want to discuss the following –

1. Is the procedure part of a diagnostic test or a treatment plan?

2. Where and when will the doctor be performing the D&C?

3. What are the preoperative precautions to be observed?

4. What are the risks involved?

Let us understand a bit more about the procedure itself

Who Needs a Dilation And Curettage (D&C)?

There can be several conditions that can prompt your gynaecologist to recommend a D&C procedure. In some cases, the doctor may remove the uterine lining and further send it for biopsy or testing to diagnose you. Some common D&C causes include -

1. Diagnosing heavy or abnormal bleeding between periods

2. Extended uterine bleeding

3. Bleeding after menopause

4. Clearing the uterine cavity after miscarriage or abortion

5. Clearing placental tissue after delivery

6. Removing cervical or uterine polyps

Sometimes, gynaecologists recommend a D&C along with a hysteroscopy. In such cases, the doctor may introduce a scope into the uterus. This scope has a camera and light attached and helps the doctor visualise the inside of the uterus. This is done for diagnostic purposes. 

How To Prepare For Dilation And Curettage (D&C)?

Dilation and curettage is a minor surgical procedure and may be done as an outpatient procedure. However, you may require hospitalisation if the doctor plans to conduct additional tests or procedures with the D&C.

Before the procedure:

1. Your doctor may recommend some blood tests or a physical examination to assess your overall health before the procedure.

2. The D&C is performed under a spinal epidural or general anaesthesia. In both cases, you will be required to abstain from eating and drinking for a few hours before your procedure.

3. You will be required to quit smoking a few days before the D&C and will need to abstain from alcohol intake for at least 24 hours.

4. Certain medicines such as blood thinners may increase the risk of complications. Your doctor will adjust your medication before the D&C.

5. Your doctor will likely recommend bringing along a friend or a family member when you come for the procedure.

What Happens During a Dilation And Curettage (D&C)?

1. You will be asked to change into a hospital gown and lie on the operating table with your feet in stirrups.

2. You will now be administered either general anaesthesia or an epidural.

3. Your doctor will now insert a speculum into your vagina. This will help open up the cervix.

4. Your doctor will now insert several rods to hold the cervix till it is dilated and open to perform the procedure.

5. Now the surgeon will remove the tissue lining through suctioning or with the help of a spoon-like instrument called the curette.

6. The tissue sample will then be sent to a laboratory, and you will be sent to the recovery room.

In rare cases, the doctor may give you medication that must be consumed the day before the procedure. This helps in cases where the procedure requires a greater dilation than usual.

What Happens After a Dilation And Curettage (D&C)?

Typically, you are asked to go home within a few hours of the D&C procedure. You can expect mild pain, light bleeding, or spotting. It is highly recommended that you rely on a friend or family member to help you through the day. You can expect to get back to your regular activities in a day or two. You will need to check with your doctor or lab for the expected time for laboratory findings of the tissue sample taken during the D&C.

Following a D&C procedure, your menstrual periods may be slightly delayed.

Signs to look out for after D&C –

If you experience any of the following symptoms after a D&C procedure, you must seek medical help immediately -

1. Heavy bleeding

2. Extreme pain, cramping, or discomfort

3. Fever

4. Abnormal vaginal discharge

What Are The Advantages Of A Dilation And Curettage (D&C)?

A D&C is a standard surgical procedure that causes minimal pain and discomfort. It is often recommended after a miscarriage because it reduces the pain and discomfort, risk of infections, and need for follow up surgeries.

D&C helps your doctor diagnose problems such as extended or abnormal bleeding. It can also help gain a good sample of endometrial cells that could be used for a biopsy.

No matter what the causes, D&C is quick and helps resolve several gynaecological conditions with no need for a hospital stay. Despite such obvious advantages, the procedure may be contraindicated in the following cases –

1. If you have a viable pregnancy and are not seeking an abortion

2. If you are allergic to the anaesthesia or any drugs that are used in the procedure

3. If you are on blood thinners or have a condition that makes blood clotting difficult.

What Are The Risks Of Dilation And Curettage (D&C)?

While largely safe, D&C does carry certain risks. These include –

1. Excess or heavy bleeding can occur as a result of the procedure. This usually occurs if the uterine lining is perforated during the procedure.

2. Due to the dilation of the cervix during the procedure, there is a greater risk of infection travelling to the uterus. Your doctor may recommend abstaining from sex and using tampons for a few days.

3. In rare cases, scar tissue forms over the uterine lining after the D&C. This is called Asherman’s syndrome. This condition can affect fertility.

4. Allergic reaction to the anaesthesia is another risk of the procedure.

If you are concerned about the D&C procedure or any risks involved, consult your gynaecologist at Max Hospital.

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