In the case of an abnormal pregnancy, it is sometimes necessary to remove the tissue from the uterus. The surgical procedure for removing the tissue is called suction dilation and curettage, or D&C for short.
Dilation and curettage is a minor surgical procedure in which your OB-GYN will dilate your cervix, either with drugs or with a surgical instrument. Then, they can clear out the tissue with a special instrument called a curette. It can be performed as an outpatient procedure, in a clinic, hospital, or at your OB-GYN’s office.
D&C is sometimes used to treat:
- Molar pregnancy, when a fertilized egg develops into a tumor instead of a fetus
- Hemorrhage after birth, caused by the placenta
- Uterine fibroids
- Uterine polyps
- Remaining tissue after a miscarriage or abortion
Sometimes, a D&C is performed along with a hysteroscopy. This is when your doctor inserts a very thin light and camera through your vagina and cervix to look into your uterus. Your uterine lining will be visible on a screen, where the doctor can assess the health of your uterus by taking samples and checking for any abnormalities.
Depending on your case, your doctor may start the dilation process a day early. A drug called Cytotec may be prescribed that you can take orally or vaginally, or they may insert a slim, absorbent implement into your cervix, which will slowly expand and open your cervix over the course of the day.
What to Expect on the Day of the Procedure
You will receive some form of anesthesia to combat the pain of the procedure. The type of anesthesia administered depends on your medical history and the circumstances for your surgery. Local anesthesia numbs a small area of the body while regional anesthesia numbs a larger area.
Light sedation usually puts you to sleep, while general anesthesia renders you completely unconscious for the duration of the procedure. Overall, the procedure is performed in a short amount of time.
Dilation and Curettage Recovery
After the procedure, your doctor may want you to spend a couple hours in the recovery room to monitor for complications. You may feel drowsy from the effects of sedation or anesthesia, and you may not be able to drive. Make sure you have a partner, close friend, or relative available to take you home.
It’s normal to experience some mild cramps and spotting for a few days after the procedure. You may take ibuprofen to relieve the pain as instructed by your physician. Avoid putting anything in your vagina (no intercourse or tampons) for at least 2 weeks after a D&C to prevent infection.
Your period may be late this month since your uterus will have to build up a new lining after a D&C. Ask your doctor for advice if you’d like to try to become pregnant soon after the procedure.
Risks of Dilation and Curettage
A D&C procedure is very safe, but no surgical procedure is without its risks. Some complications that may arise during a D&C include:
This may be treated by applying pressure to the cervix or administering stitches to stop the bleeding
Perforation of the uterus
If the surgeon accidentally punctures a hole in the uterus with a surgical instrument, the wound will usually heal on its own. However, severe perforations that damage a blood vessel or another organ may need to be surgically treated.
Surgical instruments are carefully sterilized, but there is always the risk of infection. Call your doctor if you have heavy bleeding, light bleeding that lasts three weeks or more, cramps that last for three days or more, worsening pain, vaginal odor, or a fever.
Very rarely, a D&C procedure could scar the uterine lining. This is called Asherman’s syndrome and is more common when the D&C is performed after childbirth or miscarriage. Scar tissue on the uterus can sometimes lead to abnormal or painful periods, miscarriages, or trouble getting pregnant in the future.