Dilation and curettage (D&C) refers to the dilation of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and curettage. It is a therapeutic gynecological procedure as well as the most often used method of first trimester abortion.
D&C normally refers to a procedure involving a curette, also called sharp curettage. However, some sources use the term D&C to refer more generally to any procedure that involves the processes of dilation and removal of uterine contents, which includes the more common suction curettage procedures of manual and electric vacuum aspiration.
The woman is usually put under general anesthesia before the procedure begins. A curette, a metal rod with a handle on one end and a sharp loop on the other, is inserted into the uterus through the dilated cervix. The curette is used to gently scrape the lining of the uterus and remove the tissue in the uterus. This tissue is examined for completeness (in the case of abortion or miscarriage treatment) or pathologically for abnormalities (in the case of treatment for abnormal bleeding).
A Dilatation and curettage (D&C) involves two main steps:
Dilation involves widening the opening of the lower part of the uterus (the cervix) to allow insertion of an instrument. The doctor may insert a slender rod (laminaria) into the opening to gradually cause it to widen. Or medication may soften the cervix to help it widen.
Curettage involves scraping the lining and removing uterine contents with a long, spoon-shaped instrument (a curette). The doctor may also use a cannula to suction any remaining contents from the uterus. This can cause some cramping. In many cases, a tissue sample goes to a lab for examination.
Sometimes other procedures are performed along with a D&C. For example, your doctor may insert a slender device to view the inside of the uterus (called hysteroscopy).
Risks of Dilatation and curettage
There are unfortunately risks involved with this procedure, including:
- Infections and spreading of infections
- Uterine perforation
- Future pregnancy complications
- Asherman’s Syndrome