Overview
Dilation and curettage is one of the most common procedures performed by gynecologists. Dilation and curettage (D&C) is a procedure in which material from the inside of the uterus is removed. The "dilation" refers to opening of the cervix present at the lower part of the uterus that opens into the vagina. "Curettage" refers to the scraping or removal of tissue lining the uterine cavity (endometrium) with a surgical instrument called a curette.
Indications:
Dilation and curettage can be indicated as a diagnostic test or therapeutic for a variety of conditions as the following:
Diagnostic D&C
- The main reason for a diagnostic D&C is to obtain and examine samples of the endometrium (lining of the uterus). This may be done because of abnormal uterine bleeding (heavy bleeding, bleeding between periods or bleeding after menopause); following abnormal results from a previous endometrial biopsy, test, or imaging study; or, in rare cases, to look for evidence of pregnancy tissue in a person with early abnormal pregnancy.
- Diagnostic D&C is sometimes done in combination with another procedure called hysteroscopy; this involves dilating the cervix and inserting a narrow camera to examine and photograph the inside of the uterus. The images are displayed on a monitor, allowing the physician to directly see the endometrium. This helps the physician to avoid missing any structural findings (eg, polyps or fibroids) that may be inside the uterus and to take a sample of the most visibly abnormal areas.
- Investigations of female infertility
- Investigation of uterine infection
Therapeutic D&C
- 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 normal placenta. D&C is the standard treatment for molar pregnancy.
- Retained pregnancy tissue: A D&C may be recommended for 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.