Procedure: Dilation and Curettage (D & C)

Description and Purpose

Dilation and Curettage is where the the cervix is opened, or dilated , by using metal rods of increasing size. A spoon-shaped curette is then used to scrape a tissue sample from the uterine lining.
This procedure is used both to help diagnose the cause of abnormal menstrual bleeding or infertility when an endometrial biopsy cannot be done, and as treatment, to stop heavy bleeding or remove residual tissue following miscarriage , abortion , or occasionally, childbirth .

Preparation and Procedure

Both blood and urine tests as well as tests making sure the woman is not pregnant (if the procedure is diagnostic) are carried out 1 or 2 days before the D & C. The procedure is performed under general anaesthesia, so fasting for at least 8 hours beforehand is required.
Under general anaesthesia the doctor inserts a speculum into the vagina and then uses a special clamp called a tenaculum to grip the cervix. A thin metal rod called a sound is then inserted to determine the angle of the cervical canal and the depth of the uterus. The cervix is slowly dilated, using metal rods of increasing diameter up to about 1cm/½ inch.
A spoon-shaped curette is used to scrape tissue from the uterine lining. This sample is then sent to the lab for analysis.
If the D & C is therapeutic, polyps or other unwanted tissue are removed as well.
The tenaculum and speculum are then removed.

Complications include a small risk of excessive bleeding or uterine perforation and infection. Rarely, damage to the bowel or bladder. Repeat D & Cs or overscraping may lead to scar tissue, which may cause infertility or menstrual problems .

The information in this page is presented in summarised form and has been taken from the following source(s):
1. The Yale University School of Medicine Patient's Guide to Medical Tests, Barry L. Zaret M.D., Senior Editor, published by Houghton Mifflin. Online: http://www.collectivemed.com/jump/mtest.shtml