Uterus scraping

Alternative names

Dilatation and curettage; D and C

Definition

D and C is a procedure to scrape and collect the tissue (endometrium) from inside the uterus. Dilatation ("D") is a widening of the cervix to allow instruments into the uterus. Curettage ("C") is the scraping of the contents of the uterus.

Description

D and C, also called uterine scraping, is a fairly minor surgical procedure. The procedure may be performed in the hospital or in a clinic using general or local anesthesia.

The vaginal canal is held open by a speculum, and the opening to the uterus (cervix) may be anesthetized. The cervical canal is widened using a metal rod, and a curette (a metal loop on the end of a long, thin handle) is passed through the canal into the uterine cavity. The inner layer of the uterus (endometrium) is scraped away, and the tissue is collected for examination.

Indications

Uterine scraping (D and C) may be done to:

• Diagnose conditions using the tissue samples collected (biopsies)
  
• Treat irregular or heavy bleeding
  
• Remove fetal or placental tissue - used for some elective or therapeutic abortions and to remove any remaining tissue after a spontaneous abortion (miscarriage)
  

D and C may be recommended for:

• Bleeding between periods
  
• Heavy menstrual bleeding
  
• Bleeding after intercourse
  
• Investigation of infertility
  
• Endometrial polyps
  
• Uterine cancer (early diagnosis)
  
• Thickening of the uterus (endometrial hyperplasia )
  
• An embedded IUD (intrauterine device)
  
• Therapeutic or elective abortion
  
• Miscarriage
  
• Postmenopausal bleeding, or abnormal bleeding while taking hormone replacement therapy medications
  

Risks

Risks due to anesthesia include:

• Reactions to medications
  
• Problems breathing
  

Risks of any surgery include:

• Bleeding
  
• Infection