Dilation and curettage (D&C) is a gynecologic procedure in which the cervix is widened and tissue is removed from the inner lining of the uterus. It may be performed to obtain tissue for laboratory examination or to treat conditions such as retained products of conception or abnormal uterine bleeding. D&C is considered a surgical procedure and is usually done by an obstetrician–gynecologist in an outpatient or day-surgery setting.
When and why it is used
Common indications include incomplete miscarriage, heavy or prolonged uterine bleeding that has not responded to medical therapy, sampling the endometrium when there is concern for hyperplasia or cancer, management of a molar pregnancy, and removal of small intrauterine tissue fragments. A D&C can be diagnostic, therapeutic, or both. The tissue removed is often sent for pathology to guide further care.
Before the procedure
Before a D&C patients usually undergo a clinical assessment and may have imaging such as pelvic ultrasound. Informed consent covers the reason for the procedure, expected benefits, possible complications, and alternatives. Anesthesia options include local, regional, or general anesthesia depending on patient preference, clinical factors, and setting; discuss choices with your clinician and the anesthetic team beforehand.
How the procedure is performed
With the patient positioned and appropriately anesthetized, the cervix is gently dilated to permit instrument access. A curette or suction device is introduced through the dilated cervix into the uterine cavity. The clinician removes tissue by scraping with a curette or by aspiration. Tissue is collected and handled for pathology if indicated. The procedure is generally brief and followed by a short observation period.
Risks and complications
While many D&C procedures are uncomplicated, potential risks include bleeding, infection, injury to the cervix, uterine perforation, and formation of intrauterine adhesions (Asherman syndrome) that may affect future fertility. Rarely other complications may occur. Immediate effects often include cramping and light vaginal bleeding. If infection or heavy bleeding is suspected after discharge, prompt medical evaluation is important.
Recovery and follow-up
Recovery is usually quick; many people resume routine activities within a few days but are advised to avoid heavy exercise and sexual intercourse for a short interval as directed. Pain is typically managed with analgesics, and antibiotics are used when indicated. Results from pathology may take several days; follow-up ensures healing and addresses any abnormal findings.
Alternatives and evolving practice
Less invasive diagnostic options include office endometrial biopsy or hysteroscopy-directed sampling. For management of early pregnancy loss, medical treatment with medications that promote uterine evacuation can be an alternative. In many settings, suction aspiration or hysteroscopic techniques are preferred to sharp curettage when appropriate, as they can offer advantages in safety and visualization.
Procedural details and local protocols vary; ask your clinician for individualized information and counselling. For patient information and professional guidance, consult institutional resources and clinical guidelines or trusted educational materials such as professional society pages available through professional resources, patient leaflets at your clinic, or authoritative online guidance. Additional material about the cervix and uterine anatomy can be found via institutional links here, details on anesthesia via clinical information pages here, and instrument descriptions such as the curette through standard surgical references. For basic uterus-related education see general resources here.