What is Dilation and Curettage (D and C)?

• Pre-Procedure Preparation: Before the procedure, the patient may undergo a physical examination and provide a medical history. Imaging investigations, blood tests, and other diagnostic procedures may also be conducted.
• Anesthesia: It is administered to ensure the patient is comfortable and pain-free during the procedure. The type of anesthesia used depends on the patient's condition and the doctor’s recommendation.
• Dilating the Cervix: The cervix, the narrow passage between the vagina and the uterus, needs to be dilated (opened) to allow access to the uterine cavity. This is typically achieved using a series of dilators of increasing size. The dilators are gently inserted into the cervix, gradually widening it.
• Curettage: Once the cervix is adequately dilated, the curettage part of the procedure begins. There are two main methods for this:
  • Sharp Curettage: A curette, a spoon-shaped instrument with a sharp edge, is inserted into the uterus. The doctor carefully scrapes the lining of the uterus ( endometrium) to remove tissue. This tissue will be collected for further examination to diagnose certain conditions.
  • Suction Curettage (Vacuum Aspiration): A suction device to remove tissue from the uterus. The uterus is punctured with a microscopic tube (cannula), and suction is applied to remove the tissue. This method is often used for early pregnancy termination (as in elective abortion) or to remove tissue fragments after a miscarriage.
• Inspection and Hemostasis: After the curettage is completed, the healthcare provider inspects the uterine cavity to ensure that all necessary tissue has been removed. Any areas of bleeding are controlled and cauterized (if necessary) to promote hemostasis (preventing excessive bleeding).
• Recovery: Following the procedure, patients are monitored as they recover from the anesthesia. Recovery time varies, but patients may experience mild cramping, spotting, or discomfort. Pain medication and other post-operative instructions will be provided to manage any discomfort.
• Post-Procedure Care: Patients are typically advised to rest and refrain from demanding activities for a few days after the procedure. Follow-up appointments may be scheduled to monitor recovery and address any concerns.

• Miscarriage: In some miscarriages, the tissues from a pregnancy are passed completely. In other cases, a D&C is needed to remove this tissue or to ensure that all of it has been passed.
• Abortion or pregnancy termination for the first trimester: A D&C is one method that can be used when a person chooses to terminate (end) a pregnancy.
• Treatment of molar pregnancy: A molar pregnancy is an abnormal pregnancy in which a tumor forms in place of a normal placenta. D&C is the standard treatment for molar pregnancy.
• Retained pregnancy tissue: A D&C may be recommended for the management of bleeding or to identify and remove retained (unpassed) pregnancy or placental tissue following miscarriage, abortion, or delivery.
• Prolonged or excessive vaginal bleeding: A D&C may be done as a treatment in some cases of prolonged or excessive uterine bleeding that do not respond to medical treatment.

• Diagnostic Indications
• Therapeutic Indications

Diagnostic Indications

Therapeutic Indications

• Obstetricians and Gynecologists (OB/GYNs)
• Gynecologic Surgeons
• General Surgeons

• Consultation with Your Healthcare Provider: Schedule a consultation with your gynecologist or healthcare provider who will perform the procedure. During this appointment, discuss your medical history, current medications, allergies, and any existing health conditions.
• Understand the Procedure: Ask your healthcare provider to explain the D&C procedure, including its purpose, risks, benefits, and expected outcomes. Make sure you understand the reasons for the procedure and what to expect before, during, and after.
• Pre-Procedure Tests: Your healthcare provider may request certain tests, such as blood tests, imaging studies, or a pelvic ultrasound, to assess your health and help guide the procedure.
• Anesthesia Discussion: Discuss anesthesia options with your healthcare provider. Depending on the complexity of the procedure and your health status, you may receive local, regional anesthesia or general anesthesia.
• Fasting and Medications: Your healthcare provider will provide detailed instructions regarding fasting (not eating or drinking) before the procedure, especially if general anesthesia is planned.
• Arrange Transportation: If you receive general anesthesia, Make arrangements for a ride home after the surgery, as the effects of anesthesia can impair your driving ability.
• Clothing: On the day of the procedure, wear loose-fitting, comfortable attire to the hospital or clinic. It will put you at ease and make it simpler for you to get dressed in a hospital gown if necessary.
• Personal Items: Bring any necessary personal items, such as identification, A list of your current drugs and information regarding your insurance.
• Support: Consider having a friend or family member accompany you to provide support and assistance, especially if you receive anesthesia.
• Post-Procedure Plans: Discuss post-procedure plans with your healthcare provider. You may need to take time off work or avoid certain activities for a short period while you recover.
• Questions and Concerns: Ask your healthcare professional any questions you may have at any time. Voice any concerns about the procedure, recovery, or any other aspect of your care.

• Immediate Recovery: After the procedure, until the anesthesia goes off, you will be observed in a recovery area until your vital signs stabilize.
• Pain Management: After the operation, you may experience mild to average pelvic cramps and discomfort. Your physician may provide medicines to assist you in handling this discomfort.
• Rest and Recovery: Rest is important during the first 24 to 48 hours after the procedure. You may want to take it easy and avoid strenuous activities during this time. If necessary, plan to take time off work or other obligations to allow your body to recover.
• Vaginal Bleeding and Discharge: It's common to experience some vaginal bleeding and discharge after a D&C. The bleeding may be similar to a heavy period and can last for several days to a week. Use sanitary pads instead of tampons during this time to help reduce the risk of infection.
• Sexual Activity and Tampons: Your healthcare provider will likely recommend avoiding sexual intercourse and using tampons for a certain period after the procedure. It is usually to minimize the risk of infection and promote healing.
• Follow-Up Appointment: Book a follow-up appointment to assess your recovery, discuss the results of any tests performed, and address any concerns or questions.
• Return to Normal Activities: After receiving the all-clear from your healthcare professional, you can gradually resume your regular activities. Work, exercise, and other daily activities may fall under this category. Avoid pushing yourself too much in the first week following the treatment, and pay attention to your body.
• Complications and Signs of Concern: While complications are rare, it's important to be aware of signs that may indicate a problem, such as excessive bleeding, severe pain, fever, or foul-smelling discharge. If you experience any of these symptoms, contact your healthcare provider immediately.
• Emotional Support: Some women may experience emotional ups and downs following a D&C, especially if the procedure is related to pregnancy loss. Reach out to friends, family, or a support group if you need emotional support during your recovery.

• Rest and Recovery: Give your body time to heal by getting adequate rest in the days following the procedure. Avoid strenuous physical activities and heavy lifting during this period.
• Hydration and Nutrition: Stay hydrated by drinking plenty of water. Adequate hydration can aid in the healing process. Focus on a balanced diet rich in nutrients, vitamins, and minerals to support your body's recovery.
• Pain Management: If you experience discomfort or cramping, follow your healthcare provider's recommendations for pain management. It may include taking prescribed pain medications or over-the-counter pain relievers as advised.
• Avoiding Infections: To prevent infections, follow any guidelines provided by your doctor regarding hygiene and wound care. Avoid sexual intercourse, swimming in pools or hot tubs, and using tampons.
• Emotional Well-being: Depending on the reason for the D&C, you may experience emotional changes. Seek emotional support from friends, family, or a mental health professional if needed.
• Follow-up Appointments: Attend any scheduled follow-up appointments with your healthcare provider. These appointments are important to monitor your recovery and address any concerns.
• Birth Control and Family Planning: If the D&C was related to pregnancy, discuss birth control options with your healthcare provider to ensure a healthy and well-timed pregnancy in the future.
• Return to Physical Activities: Gradually resume physical activities, such as exercise, as your doctor advises.
• Work and Daily Activities: Depending on your job and daily routine, you may need to take time off work or make adjustments to accommodate your recovery.
• Listen to Your Body: Pay attention to your body's signals. Consult your healthcare provider if you feel fatigued, in pain, or experience any unusual symptoms.
• Avoid Stress: Minimize stress as much as possible, as stress can affect the healing process. Engage in relaxation techniques like deep breathing, meditation, or yoga.