D and C
D and C is a procedure to scrape and collect the tissue (endometrium) from inside the uterus.
- Dilation ("D") is a widening of the cervix to allow instruments into the uterus.
- Curettage ("C") is the scraping of the walls of the uterus.
Dilatation and curettage; Uterus scraping; Vaginal bleeding - dilation; Uterine bleeding - dilation; Menopause - dilation
D and C, also called uterine scraping, may be performed in the hospital or in a clinic while you are under general or local anesthesia.
The health care provider will insert an instrument called a speculum into the vagina. This holds open the vaginal canal. Numbing medicine may be applied to the opening to the uterus (cervix).
The cervical canal is widened, and a curette (a metal loop on the end of a long, thin handle) is passed through the opening into the uterus cavity. The health care provider gently scrapes the inner layer of tissue, called the endometrium. The tissue is collected for examination.
Why the Procedure Is Performed
This procedure may be done to:
- Diagnose or rule out conditions such as uterine cancer
- Remove tissue after a miscarriage
- Treat heavy menstrual bleeding, irregular periods, or bleeding between periods
- Perform a therapeutic or elective abortion
Your health care provider may also recommend a D and C if you have:
- Abnormal bleeding while you are on hormone replacement therapy
- An embedded intrauterine device (IUD)
- Bleeding after menopause
- Endometrial polyps (small lumps of tissue on the endometrium)
- Thickening of the uterus
This list may not include all possible reasons for a D and C.
Risks related to D and C include:
- Puncture of the uterus
- Scarring of the uterine lining (Asherman syndrome, may lead to infertility later)
- Tear of the cervix
Risks due to anesthesia include:
- Reactions to medications
- Problems breathing
Risks of any surgery include:
After the Procedure
A D and C has few risks. It can provide relief from bleeding, and can help diagnose infection, cancer, and other diseases.
You may return to your normal activities as soon as you feel better, possibly even the same day.
You may have vaginal bleeding, pelvic cramps, and back pain for a few days after the procedure. You can usually manage pain well with medications. Avoid using tampons and having sexual intercourse for 1 - 2 weeks after the procedure.
Bulun SE. The physiology and pathology of the female reproductive axis. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 17.
Lobo RA. Abnormal uterine bleeding: ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 37.
Reviewed By: Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.