Dilation and curettage often referred to as D&C is a procedure that removes the unwanted tissues from the inside of the uterus.
This procedure is performed in certain conditions like miscarriage, abortion, heavy bleeding, uterine polyps, and cancer to ensure the inner lining of the uterus is cleaned.
To diagnose abnormal uterine bleeding that could be caused by fibroids, hormonal imbalances, or even uterine cancer. The procedure helps to treat the condition through associated procedures.
The associated surgery with Dilation and Curettage is hysteroscopy, where the doctor would additionally remove the uterine polyp and fibroid tumors.
There are some rare complications associated with the procedure -
Perforation of the uterus - Perforation is cuts or holes on the uterus. These usually heal on their own, but if an organ or blood vessel is damaged another procedure may be required to rectify it.
Damage to the cervix – can be cured by applying stitches.
Scar tissue on the uterine wall can lead to painful menstrual cycles, future miscarriages, and infertility.
Infection- can happen, but are rare.
For the dilation and curettage process, the patient is given general anesthesia.
The doctor decides the type of anesthesia depending on the purpose of the D&C and the patient's medical history.
The patient should inform the doctor-
If the patient is suspecting pregnancy.
If the patient is sensitive or allergic to any medication.
The patient has a history of bleeding disorders or is taking any blood-thinning drugs.
During the procedure, the doctor first initiates the dilation of the cervix, the opening of the uterus.
The process of dilation is time-consuming and might take a few hours or even a day. The doctor prepares the patient accordingly.
The cervix opens gradually and to assist dilation, the doctor would use medication that is given orally or inserted in the vagina.
In some cases, to soften the cervix, a rod made of laminaria is inserted into the cervix that gradually expands by absorbing the fluid in the cervix. Thereby causing the cervix to open. The doctor then uses a curette to remove uterine tissue.
Suction-based or sharp curettes can be used. The inner line of the uterus is scraped with a long, spoon-shaped instrument called a curette. The doctor might also make use of a cannula to suction the contents from the uterus.
The cervix needs to be expanded or dilated more than a standard D & C practice during a hysterectomy or a miscarriage.
The purpose of the procedure is -
To clear out tissues from the uterus as a result of a miscarriage or an abortion. This is done to prevent infection or heavy bleeding.
The remove molar pregnancy, that is a tumor, deceptive as a pregnancy.
Clearing out placenta post-delivery to stop the excessive bleeding.
Remove the non-cancerous cervical or uterine polyps.
The patient is sent to a recovery room to be kept under observation. Here the patient is observed for heavy bleeding and the anesthesia to wear off
It is an outpatient procedure and patients can go home the same day.
Your doctor will discuss the results of the procedure after the D&C or at a follow-up appointment.
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