Dilation and curettage - D&C
Curettage of the uterus (womb) is the scraping of the lining of the uterus (the endometrium). The procedure is commonly known as dilation and curettage or D&C.
When is D&C carried out?
There are two main reasons for performing a D&C:
- an evacuation D&C is performed in a recently pregnant woman to remove tissue remaining in the womb.
- a gynaecological D&C is part of the investigation of a woman who is experiencing heavy or irregular periods or vaginal bleeding after the menopause.
When is an evacuation performed in a recently pregnant woman?
After, or sometimes during, a miscarriage, the gynaecologist will examine you to see if there is any tissue from the pregnancy remaining in the womb.
An ultrasound scan is the most reliable way to determine this. An evacuation is usually advised to avoid heavy bleeding and prevent a possible infection of the uterus.
An alternative to surgery is a medical evacuation that uses tablets to cause the womb to contract and empty itself. The success rate of a medical evacuation in completely emptying the uterus is slightly less than the surgical approach, but is an option for some women.
If you miscarried at an early stage in pregnancy, or if the amount of remaining tissue is small, a D&C may not be necessary since the remaining tissue will be passed as part of the next period.
What happens during a D&C?
First you will be given a general anaesthetic by an anaesthetist.
The gynaecologist opens (dilates) the cervix with instruments called dilators, and then inserts a hollow tube through the cervix. Suction is applied to remove the retained tissue.
The procedure usually takes less than five minutes.
Warning signs
Contact your doctor if you experience any of these symptoms after a D&C:
- heavy bleeding with large clots
- severe lower abdominal pain
- bleeding
- smelly vaginal discharge
- a high temperature.
How soon can you return to work after a D&C?
Most women will take the following day off work, but, physically, you recover quickly.
Most women experience psychological effects after a miscarriage, because the pregnancy might have been anticipated with much joy. It is helpful to talk through thoughts and feelings with friends and relatives or with your midwife or doctor.
It is normal to experience irregular bleeding in the days following the D&C.
Why are gynaecological curettages performed?
Sometimes, the character or amount of a woman's period can change. Or there may be breakthrough bleeding or spotting in between periods or during sexual intercourse. Such changes can be caused by hormonal disturbances or may be due to a disease of the cervix or uterus.
Older women, especially those who experience postmenopausal bleeding, receive a gynaecological D&C.
© Copyright 1998 - 2009 NetDoctor.co.uk - All rights reserved 
