Dilatation and curettage, or D&C, is a minor operation used to diagnose or treat many conditions that cause abnormal bleeding from the womb. Definitions: dilatation means opening the cervix (neck of the womb) and making it wider; curettage means scraping a sample of the endometrium, the inner lining of the womb, for further examination.
Why is it done? Dilatation and curettage may be done to find and identify the causes of abnormal bleeding. During this procedure, a sample of tissue is taken from the womb and examined under a microscope in the laboratory to find out whether or not there are abnormal cells. This procedure is also done when a woman has had a miscarriage: if any remaining products of pregnancy are left in the womb, they are removed by dilatation and curettage. This is very important, because tissue left behind may cause infection and heavy bleeding.
The risks and complications of D&C are usually rare, but may include:
- Bleeding
- Infection or perforation of the wall of the womb (by the thin instrument passed into the womb for curettage). If perforation occurs, nearby organs are also injured and further surgery will be needed.
- Asherman syndrome (scarring and adhesions after curettage, which cause infertility and changes in menstrual flow). Danger signs after D&C that need an urgent visit to a doctor:
- Heavy bleeding from the vagina
- Fever
- Abdominal pain
- Foul-smelling vaginal discharge
Wishing you a good recovery
How D&C is done: for this procedure, the patient is placed on the gynaecological table in the operating theatre and, after general anaesthesia or spinal anaesthesia and under completely sterile conditions, a pelvic examination is done first. Then the cervix (neck of the womb) is gently opened using a tenaculum (an instrument for opening the cervix), and then tissue is scraped from all sides of the womb using a curette and sent for pathology testing.
How long does recovery take and what care is needed? Dilatation and curettage does not take long, and the patient can go home after a few hours. She may need help with daily tasks for one day.
After-effects of D&C: 1. If general anaesthesia was used, you may sometimes be troubled for a short time by slight nausea and vomiting or by feeling drowsy and weak. 2. Mild cramps. 3. Blood-stained phlegm or a little bleeding from the throat. 4. Delayed period: after D&C, a new lining grows in the womb. Your period may not come at its usual time and may be a little late.
5. Because the cervix is more open, bacteria can easily get into the womb and cause infection, so it is best to ask your doctor about when to resume sexual intercourse or use tampons.
What type of anaesthesia is used for D&C? D&C is usually done under general anaesthesia, but it may also be done under local, spinal or epidural anaesthesia. You can discuss the type of anaesthesia with your doctor and decide together.
Note: when you walk for the first time after surgery, there is a risk of falling. To prevent this, have sweet drinks; first sit in place for a few minutes, then let your legs hang down from the bed for 20 minutes, and then stand for a few minutes. If you feel dizzy or your vision goes dark, do not walk; repeat the first steps again a few minutes later, and walk with the help of your companion. You can sit down on a chair several times along the way.
Prepared and compiled by: Homa Yektapour – Education Unit
Source: Williams Gynaecology and Obstetrics
Document code: NO-BR-53