D and C

Definition

D and C is a procedure to scrape and collect the tissue (endometrium) from inside the uterus. Dilatation ("D") is a widening of the cervix to allow instruments into the uterus. Curettage ("C") is the scraping of the contents of the uterus.

Description

D and C, also called uterine scraping, is a fairly minor surgical procedure. The procedure may be performed in the hospital or in a clinic using general or local anesthesia.

The vaginal canal is held open by a speculum, and the opening to the uterus (cervix) may be anesthetized. The cervical canal is widened using a metal rod, and a curette (a metal loop on the end of a long, thin handle) is passed through the canal into the uterine cavity. The inner layer of the uterus (endometrium) is scraped away, and the tissue is collected for examination.

Indications

Uterine scraping (D and C) may be done to:

• Diagnose conditions using the tissue samples collected (biopsies)
• Treat irregular or heavy bleeding
• Remove fetal or placental tissue -- used for some elective or therapeutic abortions and to remove any remaining tissue after a spontaneous abortion (miscarriage)

D and C may be recommended for:

• Bleeding between periods
• Heavy menstrual bleeding
• Bleeding after intercourse
• Investigation of infertility
• Endometrial polyps
• Uterine cancer (early diagnosis)
• Thickening of the uterus (endometrial hyperplasia )
• An embedded IUD (intrauterine device)
• Therapeutic or elective abortion
• Miscarriage
• Postmenopausal bleeding, or abnormal bleeding while taking hormone replacement therapy medications

Risks

Risks due to anesthesia include:

• Reactions to medications
• Problems breathing

Risks of any surgery include:

• Bleeding
• Infection

Additional risks include:

• Puncture (perforation) of the uterus
• Laceration (tear) of the cervix
• Scarring of the uterine lining (endometrium)

Expectations after surgery

D and C has relatively few risks, can provide relief from bleeding, and can help diagnose infection, cancer, infertility, and other diseases.

Convalescence

Normal activities may be resumed as soon as the patient feels well, possibly even the same day. There may be vaginal bleeding, as well as pelvic cramps and back pain for a few days after the procedure.

Pain can usually be managed well with medications. Tampon use is not recommended for a few weeks, and sexual intercourse is not recommended for a few days.

Illustrations

D and C

D & C- series

Page Content:

Dilatation and curettage; Uterus scraping ; curettage dilatation; curettage dilatation picture; curettage dilatation pathophysiology; scraping uterus