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A Dilation & Curettage, or D&C, is a surgical procedure used to remove tissue from inside the uterus. In a D&C, the woman’s cervix is dilated, and the endometrium (uterine lining) is scraped or suctioned. D&C abortions typically occur within the first 16 weeks of gestation.

 

How It Works

A D&C is typically an outpatient procedure performed in a hospital or clinic.

• Preparation - Patients may receive general, regional (spinal), or local anesthesia. In some cases, medication may be administered beforehand to help soften and open the cervix.

• Dilation - The doctor inserts a speculum into the vagina to hold it open. They then insert a series of progressively thicker rods to slowly dilate (widen) the cervix.

• Curettage - A surgical instrument called a curette, a spoon shaped tool or a suction device, is inserted into the uterus to break or cut up the fetus and other tissue, vacuum out the pieces, and scrape the uterine wall to ensure everything has been removed.

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While a D&C can be used to perform an abortion, it is often used to address a variety of other medical conditions as well. Additionally, a D&C may be performed for both diagnostic and therapeutic reasons.

 

Diagnostic purposes - A doctor may perform a D&C to obtain a tissue sample or biopsy to check for certain conditions: 

• Abnormal uterine bleeding - To determine the cause of heavy or irregular bleeding, including bleeding after menopause.

• Cancer - To diagnose conditions such as uterine or endometrial cancer.

• Uterine polyps - To confirm the presence of benign growths in the uterus.

• Endometrial hyperplasia - To test for a precancerous condition where the uterine lining is too thick. 

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Therapeutic purposes - A D&C can treat or resolve several uterine conditions:

• Miscarriage - To remove tissue that remains in the uterus after a miscarriage to prevent infection or heavy bleeding.

• After childbirth - To remove pieces of the placenta that may remain in the uterus.

• Molar pregnancy - To remove a tumor that forms in place of a normal pregnancy.

• Polyps - To remove noncancerous cervical or uterine polyps. 

 

Risks and Complications

Risks can include: 

• Uterine perforation - When a surgical instrument punctures a hole in the uterus. Small holes often heal on their own, but more serious damage may require another procedure.

• Damage to the cervix - Lacerations can occur and may be treated with pressure or stitches.

• Infection - Although instruments are sterilized, there is risk of infection.

• Asherman's syndrome - In rare cases, scar tissue can form inside the uterus, potentially causing abnormal periods or infertility.