Dilation and Curettage (D and C) is a surgical procedure through which a physician explores the uterine lining and the inside of the uterus. The recovery phase is short. However, there are some risks which a patient may have to face, but they are rare.
Dilation refers to the widening or opening of the cervix and Curettage refers to the procedure when the lining of the uterus or the contents of the uterus are scraped and scooped out. The D and C surgery is performed after a miscarriage in the first trimester or in case of an abortion.
A ‘D and C’ procedure is carried out to diagnose the gynaecological reasons which cause heavy, abnormal uterine bleeding. It is also used to understand and identify the presence of cancer or to analyze the reasons behind a woman’s infertility. The procedure is also used to remove the excess uterine lining in women who suffer from polycystic ovary syndrome.
It is also done in case of a missed or incomplete miscarriage. A ‘D and C’ procedure for miscarriage uses suction to remove the uterine contents. It is used after a miscarriage to pull out the fetus and the other tissues in case the contents have not come out on their own. For healing after a miscarriage
A ‘D and C’ is performed to ward off infections in the uterus and for gynaecological conditions. Although, it should not be done under the following conditions listed below:
Follow exactly the way your doctor asks you to. However, there are few things you need to do on your own like –
There are different types of anaesthesia that can be used during D and C. However, it is up to the patient and the anaesthetist what they want to choose.
It is a medically induced coma. It can be administered as an inhaled gas or through an injection. This is the most common among all types of anaesthesia in a D and C procedure.
Spinal anaesthesia is a type of regional anaesthesia into the subarachnoid space through an injection. The drug is injected with the help of a very fine needle. The best part about spinal anaesthesia is that though the patient is wide awake, she does not have any sensation down below the waist.
Another form of spinal anaesthesia is the epidural anaesthesia. In this type, the drug is injected at a slightly different place in the spine. It eases the pain keeping the lower limbs active.
Here a small part of the body where the incision is to be made is made numb. The drug is injected into the part of the body where the incision is to be made. This form of anaesthesia is rare in a D and C procedure.
A ‘D and C’ procedure is a minor surgery in which a patient can go home on the same day after the surgery. The following are the steps to the procedure.
Once you reach the hospital, the first thing you will be asked to do is empty your bladder and wear the hospital gown.
The nurse will then ask you to lie down, and the doctor will start administering the anaesthesia.
During this procedure, the doctor first tries to understand the depth and the angle of the uterus. He does so by inserting a thin flexible piece of metal. Then he inserts a speculum; an instrument used to hold open the vaginal walls. Then he inserts a series of tapering rods, each thicker than the previous one to stretch the opening of the uterus.
Once the cervix is dilated, a spoon-shaped device called a Curette is inserted into the uterus. After scraping a little of the cervical lining, the doctor will then insert a hysteroscope. Through this instrument, the doctor can get to see the inside of the uterus to look for overgrowths in the endometrium. If in case, there are polyps or fibroids, the doctor can remove it then. Hysteroscopy in D and C is usually done to evaluate the cause of the abnormal uterine bleeding and even to rule out malignancy in menopausal patients.
The procedure takes less than 30 minutes only and the recovery time is about 24 hours maximum.
D and C is usually a very safe procedure. However, on rare occasions, patients may experience few side-effects and risks.
The minor surgery takes about 15-20 minutes and D and C recovery time are also less, unlike other surgeries. You may have to stay for a few hours after the surgery for observation. Only in rare cases, the patient may have to be hospitalized. You may experience lightheadedness for a day or cramping for few days after the D and C procedure. Therefore, you have to have someone to drive you back home from the hospital. The patient may experience light bleeding or spots. You could also suffer from Anaemia due to excessive blood loss during the procedure. Anaemia could cause weakness and heavy breathing. This can be cured by taking iron tablets. All in all, the patient can start her normal routine of doing household chores or going to work in a couple of days. Some may even start as early as the day after the surgery.
Taking care of yourself after a ‘D and C’ procedure is imperative. Here are 7 tips on how to do so:
You should call for medical help anytime you feel uncomfortable. However, here is a list of signs you should look out for after a D and C surgery.
Here are a few frequently asked questions of people which may help you to get an answer to your queries.
Bleeding for some time and then not and then bleeding again for the first four weeks after D and C is perfectly normal. It is just your hormone trying to regulate itself. Moreover, even after scrapping and scooping in the D and C procedure, a lot of uterine lining is still there to be shed which comes out through the bleeding.
Yes, it is absolutely possible to get pregnant after a D and C. However, it is wise to wait for your body to heal before you try to conceive again.
It takes about 4 to 6 weeks to get your first periods after a D and C procedure. The first flow after the D and C is different for different people. However, it is usually heavier than usual but nothing to be worried about.
Advances in the field of medicine have provided an alternative treatment to the traditional method of D and C. However not all doctors are trained or equipped to try out these alternatives. Therefore, the D and C procedure will continue to be the standard diagnostic or therapeutic method for gynaecological conditions.