Dilation and curettage (D&C)

Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. Health care professionals perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.

Dilation and curettage is used to diagnose or treat a uterine condition.

Complications from dilation and curettage are rare. However, there are risks, including: Perforation of the uterus. This occurs when a surgical instrument pokes a hole in the uterus. This happens more often in women who were recently pregnant and in women who have gone through menopause. Most perforations heal on their own. However, if a blood vessel or other organ is damaged, a second procedure might be needed to repair it. Damage to the cervix. If the cervix is torn during the D&C , your doctor can apply pressure or medicine to stop the bleeding or can close the wound with stitches (sutures). This might be prevented if the cervix is softened with medication before the D&C . Scar tissue on the uterine wall. Rarely, a D&C results in development of scar tissue in the uterus, a condition known as Asherman's syndrome. Asherman's syndrome happens most often when the D&C is done after a miscarriage or delivery. This can lead to unusual, absent or painful menstrual cycles, future miscarriages and infertility. It can often be treated with surgery. Infection. Infection after a D&C is rare. Contact your health care team if after a D&C you have: Bleeding that's heavy enough that you need to change pads every hour. Lasting dizziness or lightheadedness. Fever. Cramps lasting more than 48 hours. Pain that gets worse instead of better. Foul-smelling discharge from the vagina.

Dilation and curettage can be done in a hospital, clinic or health care professional's office, usually as an outpatient procedure. Before the procedure: Follow your care team's instructions on limiting food and drink. Arrange for someone to take you home because you may be drowsy after the anesthesia wears off. Allow time for the procedure and a few hours of recovery afterward. In some cases, you might start to have your cervix dilated a few hours or even a day before the procedure. This helps your cervix open gradually and is usually done when your cervix needs to be dilated more than in a standard D&C , such as during pregnancy terminations or with certain types of hysteroscopy. To promote dilation, your doctor may use a medication called misoprostol (Cytotec) — given orally or vaginally — to soften the cervix. Another dilation method is to insert a slender rod made of laminaria into your cervix. The laminaria gradually expands by absorbing fluid in your cervix, causing your cervix to open.