What Is a Dilation and Curettage (D&C)?

A dilation and curettage, usually called a D&C, is a procedure in which the cervix is dilated and the lining of the uterus is surgically scraped. This is sometimes done after a miscarriage to further evaluate the uterus if abnormal uterine bleeding occurs.

This article covers why and how it’s done to help you prepare for the procedure.

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Why It’s Done

A D&C removes tissue from the uterine lining. It can be used to treat or prevent complications associated with a miscarriage or to evaluate other uterine bleeding problems when someone is not pregnant.

A few of the most common reasons it's done following a miscarriage include:

The procedure can also be used to gather a sample for testing the chromosomes of the fetus. Couples can use this information to understand if their baby had any genetic abnormalities.

In some cases, tissue samples are taken during a D&C procedure to diagnose conditions like uterine polyps and uterine cancer

How to Prepare

Your doctor will help you prepare for the procedure and provide written instructions for a reminder.

Before the procedure, your doctor will review your medical history, give you time to ask questions, and go over consent paperwork.

Let your doctor know if:

  • You have a bleeding disorder or take blood thinners
  • You have a known allergy to medications, anesthesia, or latex

The procedure can be done in a hospital, clinic, or doctor's office. Depending on the type of anesthesia being used, you may need to fast for about 12 hours before the procedure.

You may be given:

  • General anesthesia (meaning you won’t be awake for the procedure)
  • Local anesthesia (meaning you will be awake but won’t feel the procedure)

Your doctor may recommend starting to dilate the cervix from a few hours to up to a day before the procedure based on your medical needs. Starting the dilation process before the procedure allows time for the cervix to open more slowly than a standard dilation.

You will likely be asked to empty your bladder before the procedure begins.

What Happens During the Procedure

At the start of the procedure, you will be given the type of anesthesia you discussed with your doctor. With either form of anesthesia, you won’t be able to feel any pain or discomfort during the D&C procedure.

Steps of a D&C

  1. You will lie on an exam table with your feet supported in stirrups, like when you receive a pelvic exam or Pap smear.
  2. Your doctor inserts a speculum into your vagina so that they can see your cervix.
  3. To help dilate your cervix, your doctor may have given you medication or will insert a thin rod followed by a thicker one. They will continue this process with thicker rods until the cervix is opened enough for the procedure.
  4. Your doctor will remove the dilation rods and insert a spoon-shaped instrument with sharp edges to remove uterine tissue. Your doctor may also use a suction device to remove tissue.
  5. The collected tissue is usually sent to a lab for testing.

After the Procedure

Once completed, you will stay in the same room or be taken to a recovery room to rest. The amount of time before you can leave after the procedure will depend on the type of anesthesia given.

With general anesthesia, you will be given more time to wake up. Your blood pressure, heart rate, and breathing will be monitored closely. When you are alert, you may be discharged home. Plan to have someone drive you home in case you are drowsy from the medication.

If you were given local anesthesia, you would likely be able to leave more quickly than with general anesthesia.

You may want to wear a sanitary pad after the procedure in case you experience spotting or bleeding.

Your doctor may recommend a few days of avoiding:

  • Strenuous activity
  • Douching
  • Tampons
  • Sexual intercourse

Recovery

For a few days after the D&C, you may experience some fatigue, light bleeding, and light cramping. Your doctor may recommend a pain reliever in case you have cramping.

Bleeding

Bleeding after a D&C procedure is common, and you may want to wear a sanitary pad for a few days. It is not recommended to use a tampon because this could increase your risk of infection.

If you have menstrual periods, the timing of your cycle will likely change because of the procedure. It could begin earlier or later than expected.

You will likely be able to resume your normal daily activities within a couple of days following the D&C procedure, but follow your doctor's recommendations for any limitations.

Your doctor will likely have you schedule a follow-up visit for a checkup and review results from the tissue testing if you had the procedure for a diagnosis.

Complications

A D&C is considered a low-risk procedure, and complications are rare. However, with any procedure, some complications could happen, such as:

  • Reaction to the anesthesia
  • Infection
  • Perforation or damage to the uterus or cervix
  • Developing scar tissue on the uterine wall
  • Damage to a blood vessel

Complications are uncommon, but if you experience any of the following symptoms after a D&C, contact your healthcare provider:

  • Fever
  • Cramps lasting longer than 48 hours
  • Worsening pain
  • Foul-smelling discharge
  • Heavy bleeding

Summary

A dilation and curettage, usually called a D&C, is a procedure in which the cervix is dilated and the lining of the uterus is removed. The risk for complications is low.

A Word From Verywell

The D&C procedure is a common one. If you experience severe cramping, heavy bleeding, or fever after the procedure, don’t hesitate to contact your doctor.

Most women will resume their periods within four to six weeks after the procedure. If it was done to treat miscarriage, discuss with your doctor the best time to try again, if you choose to.

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Article Sources
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  1. Cleveland Clinic. Dilation and curettage (D&C). Updated March 15, 2021.

  2. D’ippolito S, Di Simone N, Orteschi D, et al. The chromosome analysis of the miscarriage tissue. Miscarried embryo/fetal crown rump length (Crl) measurement: A practical use. PLoS One. 2017;12(6). doi:10.1371/journal.pone.0178113