to help evaluate some cases or infertility, or inability to have children
A hysteroscopy is almost always done with the D&C. This allows a doctor to look at the lining of the cervix and uterus before doing the D&C.
How is the procedure performed? Dilatation and curettage is usually done in a surgical centre, hospital or office setting. It is often an day case procedure. This means that a woman can go home on the same day as the procedure. A sedative medication or general anaesthesia is given for the D&C. General anaesthesia is when a woman is put completely to sleep with medications.
After a woman has a pelvic exam to check the size and direction of her uterus, a tool called a speculum is placed inside her vagina. This tool, which is also used during a Pap smear, allows the cervix to be seen. A special tool straightens the cervix and instills local numbing medication if general anaesthesia is not used. Special rods of increasing size are passed through the opening of the cervix. Once the opening is wide enough, the doctor can put other tools into the uterus.
In a D&C, the main tool put into the uterus is known as a curette, or scraper. This tool is used to scrape off the inner lining of the uterus. Scraping off the lining of the uterus may stop some types of vaginal bleeding and will terminate a pregnancy.
This tissue that was scraped off is sent to the laboratory. This tissue can then be examined with a microscope if needed. For example, the tissue scraped off may contain cancer of the uterus, which can be seen in the scrapings under the microscope.
What happens right after the procedure? In most cases, a woman is observed for an hour or two in a recovery area. This allows time for the anaesthetic to wear off and make sure a woman is stable. If there is no reason to stay in the hospital, most women can then go home. Some mild cramping pain is common right after the procedure, but often quickly goes away.
What happens later at home? A D&C is considered minor surgery. No cutting or stitches are needed. Afterwards, a woman:
may go back to normal activities the next day. If only local numbing medication was used and no sedatives were given, a woman can return to regular activities within a few hours.
may be sleepy for several hours if she had general anaesthesia. People should not drive or use heavy machinery for 24 hours after having general or total anaesthesia.
may have cramps and vaginal bleeding or spotting. This is considered normal after the procedure.
may take pain relievers such as paracetamol or ibuprofen for discomfort.
should not put anything into her vagina for about 1 week. This includes tampons, douches, and having sexual intercourse. Avoiding these will help to prevent infections.
What are the potential complications after the procedure? Though uncommon, the complications of D&C may include:
reactions to medications, such as anaesthesia, pain relievers and antibiotics
problems with the anaesthetic, such as allergies or other reactions and difficulty waking up or breathing
heavy vaginal bleeding or passage of clots
infection of the uterine lining, pelvic organs or the surrounding area
developing a hole in the uterus
scarring of the uterus from too much scraping
damage to the cervix
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
