Dilation and Curettage (D&C)

The dilation and curettage procedure is also referred to as D&C procedure. The D stands for dilation which means to enlarge while the C stands for curettage which means scraping. This procedure therefore involves expanding or enlarging the entrance of a woman’s uterus to enable a thin, sharp instrument to scrape away the lining of the uterus so as to take tissue samples.

When the Dilation and Curettage procedure is used  

This procedure is often used for the following conditions

·      Irregular bleeding – one may experience irregular bleeding from time to time and this includes spotting between periods. If this spotting progresses into continuous mid cycle bleeding, then your health care provider may perform the D&C procedure to try and establish the cause of bleeding.

·      Too much bleeding – long and heavy periods or bleeding after menopause could signal a number of problems. If this goes on for some time, then your doctor may try to establish the cause and this could be done through hysteroscopy along with D&C.

·      Therapeutic D&C – this is often planned as treatment when the source of a problem has already been established. An example is a situation in which there is an incomplete miscarriage. Also, if there is a full-term delivery and for some reason the uterus fails to push out all the fetal or placental tissues inside of it resulting in excess bleeding that can even be life threatening, dilation and curettage can be used by your doctor to remove any remaining tissue.

When D & C may not be done 

·      If you have a pelvic infection that involves your reproductive tract, then there are chances that the surgical instruments that will enter the cervix and vagina may carry the bacteria into your uterus. Infected tissue may also be injured in the process. It will therefore be best that your doctor waits until after the infection is cleared up with antibiotics before the D&C procedure can be performed.

·      If you have blood clotting disorder – doctors often rely on the natural ability of the body to clot to stop bleeding after curettage. Women with blood disorders are therefore not given this surgery.

·      If you have serious medical conditions like heart and lung problems, then it may be difficult to be administered with anesthesia as well as the D&C procedure.

Risks of the D&C procedure 

·      Hemorrhage – although heavy bleeding is rare it can happen if surgical instruments injure the wall of the uterus. Heavy bleeding may also occur if an undetected fibroid is cut in the process of Curettage.

·      Infection – there is always the possibility of infections arising from instruments being inserted into the uterus. However, most infections can easily be cured using antibiotics.

·      Perforated uterus – although this is a rare complication, it is more common in women with uterine infections at the time the D&C procedure is carried out, in women who are elderly and postmenopausal as well as if the procedure is being done for a miscarriage.

·       Asherman Syndrome – this is a rare complication and involves scar tissues forming as a result of aggressive scraping or abnormal reaction to the scraping.