D&C (dilatation and curettage) is a gynecological procedure in which the lining of the uterus (endometrium) is scraped away. A form of D&C (in effect a curettage without dilatation) is carried out after an incomplete abortion, when it is called an ERPC (evacuation of the retained products of conception). ERPC is carried out after a hysteroscopy has identified what remains in the uterus. A D&C is usually performed under a brief general anesthetic, on a hospital outpatient basis.

Why Is It Done?

These days, a D&C is usually done to remove the lining of the womb in order to find out the cause of heavy menstrual bleeding (menorrhagia), or for other uterine problems such as polyps or misplaced intrauterine coils (IUDs).

In scraping away the lining, D&C can treat the problems it finds at the same time. It was traditionally used as a means of terminating an early pregnancy, although it is very rarely employed for this purpose these days.

How Is It Done?

• First, a speculum is inserted into the vagina to separate the vaginal walls so that the cervix can be seen. A series of rods are then inserted to dilate the cervix.
• If the procedure is being performed to check for polyps, the cervix is dilated and a polyps forceps explores the uterine cavity, grasping and removing any polyps that are found. Finally a spoon-shaped instrument, the curette, is inserted into the womb to scrape away the lining.
• The scrapings from the curette are examined for abnormalities under a microscope in a laboratory.
• Mter the D&C you will need to rest and recover for several hours before going home. You should take it easy for a day or so afterward, but you shouldn’t experience any problems. You can resume sexual relations within a week or so, or whenever you feel comfortable. Your menstrual cycle will recommence within about six weeks.
• To perform an ERPC after an incomplete abortion, the procedure varies a little. There is usually no need to dilate the cervix (it will remain open if any conception material remains), so a sponge forceps is used with a curette to gently clean out the placenta and any fetal material.

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