Patient education: Dilation and curettage (D&C) (The Basics)

What is dilation and curettage? — 

This is a procedure to remove tissue from the inside of the uterus (figure 1). It is also called a "D and C" or "D&C."

During a D&C, a doctor first opens, or "dilates," the cervix. (The cervix is the bottom part, or the "neck," of the uterus.) Then, they use a surgical tool called a "curette" to scrape and remove tissue from the uterus. The tissue can be checked for abnormal cells, cancer, or other problems.

A D&C is done in an operating room in a hospital or surgical center.

Why might I get a D&C? — 

Your doctor might do a D&C to:

●Stop severe vaginal bleeding – For example, you might have a D&C if your period is too heavy.

●Figure out the cause of abnormal bleeding – For example, you might have a D&C if you have very heavy periods, or if you have vaginal bleeding after going through menopause. (Menopause is when a person stops having periods.) This might help your doctor figure out what is causing the problem.

●Get more information after an abnormal result from another test – For example, if you had a test to check for uterine cancer, your doctor might do a D&C to learn more.

Doctors can also do a D&C for other reasons. In pregnant or recently pregnant people, a doctor can do a D&C to:

●Remove any pregnancy tissue that is left in the uterus after pregnancy loss – Pregnancy loss, or "miscarriage," is when a pregnancy ends on its own.

●Remove any pregnancy tissue that is left in the uterus after childbirth

●Remove an abnormal growth called a "molar pregnancy" that has formed in the uterus

●Do an abortion (end a pregnancy) during the first trimester

How do I prepare for a D&C? — 

The doctor or nurse will tell you if you need to do anything special to prepare. In some cases, the doctor will give you medicine to help dilate your cervix the night before the procedure.

Before the procedure, your doctor will do an exam. They might send you to get tests, such as:

●Lab tests

●Ultrasound or other imaging tests – These create pictures of the inside of the body.

Your doctor will also ask about your "health history." This involves asking about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes prescription and "over-the-counter" medicines, plus any herbal supplements. It helps to write down and bring a list of your medicines, or bring a bag with all your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

●When your last menstrual period was (if you still have periods)

You will also get information about:

●Eating and drinking before the procedure – You might need to "fast" before the procedure. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure.

●What help you will need when you go home – For example, you might need someone else to bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during a D&C? — 

When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You might get anesthesia medicines to make you unconscious so you can't feel, see, or hear anything during the procedure. Or you might be awake for the procedure but get "sedative" medicines to make you relax and feel sleepy.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●Your doctor will help place your feet in footrests, so they can do a pelvic exam.

●They will use a device called a "speculum" to gently push apart the walls of your vagina. This lets them see your cervix. Then, they will use other tools to open, or "dilate," your cervix.

●They might also do a test called a "hysteroscopy" at this time. For a hysteroscopy, they put a small camera inside the uterus to look for problems. If they find anything concerning, they will often remove it.

●They will put a curette through your vagina and cervix, and up into your uterus. They will use this to scrape and remove tissue from your uterus.

●They will remove the tools through your vagina. If there is any bleeding from your cervix, they might put some medicine on the area to stop the bleeding.

●A D&C usually takes about 30 minutes or less.

What happens after a D&C? — 

You will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●You might have mild cramping and light vaginal bleeding, or "spotting." These can last for a few days. If you have pain, your doctor might recommend taking a pain-relieving medicine, such as ibuprofen (sample brand names: Advil, Motrin).

●Your doctor or nurse will tell you when you can go back to your usual activities. They will also tell you when it is safe to have sex and put things, such as tampons, in your vagina.

●Your doctor will probably recommend you do not drive or go to work for the rest of the day.

If you had tests done on the tissue from your uterus, your doctor or nurse will talk to you about when to expect the results.

What are the risks of a D&C? — 

Your doctor will talk to you about all the possible risks, and answer your questions. Possible risks include:

●A tear in the uterus

●Injury to the cervix

●Infection

●Areas of scar tissue forming in the uterus

These risks are rare. But if any of these things happen, your doctor will tell you if you need any other treatments.

When should I call the doctor? — 

Call your doctor or nurse if you have any of these problems after a D&C:

●Fever higher than 100.4°F (38°C), or chills

●Cramps that last more than 2 days

●Pain that gets worse

●Heavy vaginal bleeding, or vaginal bleeding that lasts more than 2 weeks

●Vaginal discharge that is green or smells bad

More on this topic

Patient education: Endometrial ablation (The Basics)
Patient education: Hysteroscopy (The Basics)
Patient education: Heavy periods (The Basics)
Patient education: Pregnancy loss (The Basics)
Patient education: Procedural abortion (The Basics)

Patient education: Dilation and curettage (D&C) (Beyond the Basics)
Patient education: Abnormal uterine bleeding (Beyond the Basics)
Patient education: Pregnancy loss (Beyond the Basics)
Patient education: Abortion (pregnancy termination) (Beyond the Basics)