Dilatation And Curettage
Dilatation and curettage (D&C) is a procedure that scrapes out the inside lining of the uterus.
Who is a candidate for the procedure?
Usually D&C is done for one of the following reasons:
- to diagnose and possibly treat abnormal vaginal bleeding
- to perform an abortion
- to treat an incomplete miscarriage or abortion
- to diagnose and possibly treat vaginal bleeding after childbirth
- to help detect cancer of the uterus
- to help evaluate some cases or infertility, or inability to have children
In some cases, a sample of the uterine lining is taken before D&C is done. This is called an endometrial biopsy. Or a tiny telescope, called a hysteroscope, may be used before D&C. This allows a doctor to look at the lining of the cervix and uterus before doing the D&C.
How is the procedure performed?
Dilatation and curettage is usually done in a surgical center, hospital or office setting. It is often done as an outpatient, meaning that a woman can go home on the same day as the procedure.
A sedative medicine or even general anesthesia may be given before D&C. General anesthesia is when a person is put completely to sleep with medications.
After a woman has a pelvic exam to check the size and position of her uterus, a tool called a speculum is placed inside her vagina. This tool, which is also used during a Pap smear, allows the cervix to be seen. A special tool straightens the cervix and instills local numbing medicine if general anesthesia is not used. Special rods of increasing size are passed through the opening of the cervix so as to dilate the cervix.
Once the opening is wide enough, the healthcare professional can put other tools into the uterus.
In a D&C, the main tool put into the uterus is known as a curette, or scraper. This tool is used to scrape off the inner lining of the uterus. Scraping off the lining of the uterus may stop some types of vaginal bleeding and will terminate a pregnancy.
This tissue that was scraped off (curettaged) is sent to the lab. This tissue can then be examined with a microscope if needed. For example, the tissue scraped off may contain cancer of the uterus, which can be seen in the scrapings under the microscope.