Dilation and curettage
| Background | |
| Abortion type | Surgical |
| First use | Late 19th century |
| Gestation | 4-12 weeks |
| Usage | |
| WHO recommends only when manual vacuum aspiration is unavailable | |
| United States | 1.7% (2003) |
| Medical notes | |
| Undertaken under heavy sedation or general anesthesia. Risk of perforation. Day-case procedure | |
Dilation (or dilatation) and curettage (D&C) refers to the dilation (widening/opening) of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping (curettage). It is a therapeutic gynecological procedure as well as the most often used method of first trimester miscarriage or abortion.
D&C normally refers to a procedure involving a curette, also called sharp curettage. However, some sources use the term D&C to refer more generally 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.
The woman is typically put under monitored anesthesia care (MAC) before the procedure begins. The first step in a D&C is to dilate the cervix. This can be done with Hegar dilators. A curette, a metal rod with a handle on one end and a sharp loop on the other, is then inserted into the uterus through the dilated cervix. The curette is used to gently scrape the lining of the uterus and remove the tissue in the uterus. This tissue is examined for completeness (in the case of abortion or miscarriage treatment) or by pathology for abnormalities (in the case of treatment for abnormal bleeding).
D&Cs are commonly performed for the diagnosis of gynecological conditions leading to 'abnormal uterine bleeding'; to resolve abnormal uterine bleeding (too much, too often or too heavy a menstrual flow); to remove the excess uterine lining in women who have conditions such as polycystic ovary syndrome (which cause a prolonged buildup of tissue with no natural period to remove it); to remove tissue in the uterus that may be causing abnormal vaginal bleeding, including postpartum retained placenta; to remove retained tissue (also known as retained POC or retained products of conception) in the case of a missed or incomplete miscarriage (in which some of the tissue remains in the uterus and the cervix stays open. This may increase a woman's risk of infection and continued bleeding}; and as a method of abortion. In contrast, D&C remains 'standard care' for missed and incomplete miscarriage in many countries despite the existence of alternatives currently used for abortions.
...
Wikipedia