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D and C
Definition
D and C is a procedure to scrape and collect the tissue (endometrium) from inside the uterus.
- Dilation ("D") is a widening of the cervix to allow instruments into the uterus.
- Curettage ("C") is the scraping of the walls of the uterus.
Alternative Names
Dilatation and curettage; Uterus scraping
Description
D and C, also called uterine scraping, may be performed in the hospital or in a clinic while you are under general or local anesthesia.
The health care provider will insert an instrument called a speculum into the vagina. This holds open the vaginal canal. Numbing medicine may be applied to the opening to the uterus (cervix).
The cervical canal is widened, and a curette (a metal loop on the end of a long, thin handle) is passed through the opening into the uterus cavity. The health care provider gently scrapes the inner layer of tissue, called the endometrium. The tissue is collected for examination.
Why the Procedure Is Performed
This procedure may be done to:
- Diagnose or rule out conditions such as uterine cancer
- Remove tissue after a miscarriage
- Treat heavy menstrual bleeding or irregular periods (See: Bleeding between periods)
- Perform a therapeutic or elective abortion
Your health care provider may also recommend a D and C if you have:
- Abnormal bleeding while on hormone replacement therapy
- An embedded intrauterine device (IUD)
- Bleeding after menopause
- Endometrial polyps
- Thickening of the uterus
This list may not include all possible reasons for a D and C.
Risks
Risks related to D and C include:
- Puncture of the uterus
- Scarring of the uterine lining (Asherman syndrome, may lead to infertility later)
- Tear of the cervix
Risks due to anesthesia include:
- Reactions to medications
- Problems breathing
Risks of any surgery include:
- Bleeding
- Infection
After the Procedure
A D and C has few risks. It can provide relief from bleeding, and can help diagnose infection, cancer, and other diseases.
You may return to your normal activities as soon as you feel better, possibly even the same day.
You may have vaginal bleeding, pelvic cramps, and back pain for a few days after the procedure. You can usually manage pain well with medications. Avoid using tampons and having sexual intercourse for 1 - 2 weeks after the procedure.
References
Lobo RA. Abnormal uterine bleeding: ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 37.
Bulun SE. The physiology and pathology of the female reproductive axis. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 17.
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
