Dilation and curettage
Dilation and curettage
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Dilation and curettage

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Dilation and curettage

Dilation (or dilatation) and curettage (D&C) is a medical procedure that dilates (widens or opens) the cervix and surgically removes tissue from the lining of the uterus by scraping or scooping (curettage). The D&C gynecologic procedure is used for treatment, diagnostic and therapeutic purposes.

D&C can be used to end an unwanted pregnancy or to remove the remains of a non-viable fetus. It can also be used to remove the placenta after childbirth, abortion, or miscarriage. D&C is a commonly used method for first trimester abortion or miscarriage. D&C can also be used to remove tissue from the uterus for diagnostic purposes.

D&C normally refers to a procedure involving a curette, also called sharp curettage. However, some sources use the term D&C to refer to any procedure that involves the processes of dilation and removal of uterine contents which includes the more common suction curettage procedures of manual and electric vacuum aspiration.

D&Cs may be performed in pregnant and non-pregnant patients, for different clinical indications. Such examples are for early abortion, removing the remains of a non-viable pregnancy or retention of placenta from a pregnancy loss/abortion. Treatment of menopause induced anomalies with menstrual cycle.

A D&C may be performed early in pregnancy to remove pregnancy tissue, either in the case of a non-viable pregnancy, such as a missed or incomplete miscarriage, or an undesired pregnancy, as in a surgical abortion.

Dilation and curettage has been declining as a method of abortion, due to medication-based non-invasive methods of abortion, such as misoprostol and mifepristone. Suction curettage is still the most common and preferred method to ensure complete removal of remains, as the method is a completed process used for termination of a first-trimester pregnancy. The World Health Organization recommends D&C with a sharp curette as a method of surgical abortion only when manual vacuum aspiration with a suction curette is unavailable.

For patients who have recently given birth, a D&C may be indicated to remove retained placental tissue that does not pass spontaneously or for postpartum hemorrhage.

D&Cs for non-pregnant patients are commonly performed in tandem with Hysteroscopy another diagnostic procedure, for the diagnosis of gynecological conditions usually involving abnormal bleeding; during menopause or with various abnormal structures growing within the uterus to remove the excess uterine lining in women who have conditions such as polycystic ovary syndrome; to remove tissue in the uterus that may be causing abnormal uterine bleeding, such as endometrial polyps or uterine fibroids; or to diagnose the cause of post-menopausal bleeding, such as in the case of endometrial cancer.

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