Dilation and Curettage (D&C) is a common gynecological procedure that involves dilating the cervix and scraping or suctioning tissue from the lining of the uterus. It is performed for both diagnostic and therapeutic reasons and is generally considered safe and effective. This procedure in dilation and curettage surgery is crucial for various medical outcomes.
Understanding the step-by-step process of the D&C procedure can help reduce anxiety and help patients feel more prepared.
What is Dilation and Curettage (D&C)?
D&C is a minor surgical procedure often used to:
- Diagnose the cause of abnormal uterine bleeding
- Treat miscarriage or incomplete abortion
- Remove molar pregnancy tissue
- Biopsy the endometrium for cancer or precancerous changes
- Remove uterine polyps or retained placenta
The procedure gets its name from its two main steps:
Understanding the procedure in dilation and curettage surgery can help patients navigate their healthcare journey effectively.
- Dilation – Opening of the cervix
- Curettage – Removal of the uterine lining using a curette or suction device
When is D&C Recommended?
A gynecologist may recommend a D&C for several medical conditions:
- Miscarriage management (to remove remaining pregnancy tissue)
- Surgical abortion (especially in early pregnancy)
- Heavy or irregular periods
- Postmenopausal bleeding
- Endometrial polyps or fibroids
- Suspected uterine cancer
- Incomplete delivery (retained placenta)
Preparing for a D&C Procedure
Medical Evaluation
Before the procedure, your doctor will:
- Review your medical history
- Perform a physical and pelvic exam
- Order relevant tests like pregnancy test, ultrasound, or blood tests
Informed Consent
You’ll be asked to sign a consent form after the procedure and its risks are explained.
Anesthesia Plan
You’ll discuss what type of anesthesia will be used:
- Local anesthesia: Numbs the cervix
- Conscious sedation: You’re awake but relaxed
- General anesthesia: You’re completely asleep
The choice depends on the type of D&C and your medical condition.
Fasting Guidelines
You may need to avoid food and drink for 6–8 hours before the procedure if anesthesia will be used.
Procedure in Dilation and Curettage
Arrival at the Facility
- You’ll arrive at the hospital or outpatient clinic
- A nurse will check your vitals (blood pressure, pulse, temperature)
- You’ll change into a surgical gown
Administration of Anesthesia
- Depending on the plan, local, regional, or general anesthesia will be administered
- An IV line may be inserted for fluids and medications
Positioning and Preparation
- You’ll be placed on an examination table in the lithotomy position (legs in stirrups)
- The vaginal area is cleaned with an antiseptic solution to reduce infection risk
Insertion of Speculum
- A speculum is gently inserted into the vagina to hold it open
- This allows the doctor to visualize the cervix
Cervical Dilation
- The cervix is gradually widened using dilators—thin rods that increase in diameter
- If necessary, medications like misoprostol may be given beforehand to soften the cervix
Curettage
Depending on the type of D&C, one of the following methods is used:
- Suction Curettage (Vacuum Aspiration) :- A thin plastic tube is inserted into the uterus. A gentle suction device removes tissue from the uterine lining. Common in first-trimester abortions or incomplete miscarriages
- Sharp Curettage :- A surgical instrument called a curette (spoon-shaped) is used to manually scrape the uterine lining. Often used in diagnostic D&C or for endometrial biopsy
- Hysteroscopic-Guided D&C :- A hysteroscope (thin camera) is inserted through the cervix to view the uterus. The doctor performs curettage under direct visualization, improving precision
Completion of Procedure
- Once the necessary tissue is removed, the instruments are withdrawn
- The cervix begins to naturally close
- The collected tissue may be sent to a lab for histopathology
Post-Procedure Monitoring
- You’ll be taken to a recovery room
- Vitals are monitored until the anesthesia wears off (usually 1–2 hours)
- Most patients can go home the same day
Aftercare and Recovery
What to Expect:
- Mild cramping similar to menstrual cramps
- Spotting or light bleeding for a few days
- Fatigue for 24–48 hours
Do’s and Don’ts:
- Rest for at least 24 hours post-procedure
- Avoid tampons, intercourse, or douching for at least 1–2 weeks
- Take pain relievers as prescribed
- Drink plenty of fluids and eat light meals
Follow-Up:
- A follow-up visit may be scheduled in 1–2 weeks
- Lab results (if biopsy was done) will be discussed
- Any further treatment (like hormone therapy) may be planned
Risks and Complications
Although D&C is generally safe, potential risks include:
- Uterine perforation – Rare, occurs when an instrument passes through the uterine wall
- Infection
- Heavy bleeding
- Asherman’s Syndrome – Scar tissue formation in the uterus, especially after repeated D&Cs
- Incomplete procedure – Sometimes tissue may remain and a second D&C may be required
When to Seek Immediate Medical Help
Contact your doctor if you experience:
- Heavy bleeding (soaking more than 1 pad per hour)
- Severe abdominal pain
- Fever or chills
- Foul-smelling vaginal discharge
- Fainting or dizziness
Conclusion
The procedure of Dilation and Curettage (D&C) may sound complex, but in most cases, it is a safe and routine surgical intervention. Understanding each step—from preparation and anesthesia to recovery and risks—can empower patients and reduce stress.
Whether your D&C is for diagnosis or treatment, always follow your gynecologist’s advice and don’t hesitate to ask questions. Being informed is the first step to taking control of your reproductive health.
