What is a Dilation and Curettage and why is it Done?
By Dr. Jen Lincoln (Bundoo®). Edited by Dr. Kate Dudek
A Dilation and Curettage (D&C) is a minor surgical procedure used to remove tissue from a woman’s uterus. First the cervix is expanded (dilated) and then scraped with a spoon-shaped instrument known as a curette. The cervix forms the opening of the uterus and is located above the vagina. It normally only dilates during childbirth, but doctors can induce dilation if there is a medical need. Sometimes they will use medication to soften and dilate the cervix; other times, they will insert a laminaria stick, which is a narrow rod that absorbs fluid from the cervix, causing it to dilate. Ideally, during a D&C, the cervix will dilate by approximately 1.3 cm. The procedure is sometimes performed alongside a hysteroscopy, so that the doctor can visualise and evaluate the lining of the uterus (the endometrium) at the same time.
As with routine gynaecological check ups and pap smear tests, a D&C can usually be performed in a doctor’s office, without sedation or anaesthetic. However, anxious patients may benefit from undergoing the procedure in the operating room with local anaesthesia. Often over-the-counter painkillers are the only medication required and, once the cervix is sufficiently dilated the process should only take a couple of minutes.
Whilst many women have heard of a D&C, not all will know what the full scope of the procedure is and what it can be used for:
- To remove retained tissue after a miscarriage
- To take a sample of the lining of the uterus (the endometrium) for diagnosis purposes in cases of abnormal uterine bleeding, for example, heavy, prolonged periods or postmenopausal bleeding
- As a treatment to thin the lining of the uterus, often used for women who have persistent heavy periods
- To treat a molar pregnancy
- To remove a retained placenta or treat a postpartum hemorrhage.
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