Dilation and curettage (D&C) is the removal of tissue from inside the uterus for diagnostic or treatment purposes of abnormalities caused by the uterus, such as abnormal vaginal bleeding, miscarriage, or sometimes to remove retained placental tissue inside the uterus to clean and prevent dangerous bleeding or infection.
Conditions that should be examined or treated with dilation and curettage
- Abnormal bleeding from the uterine cavity or bleeding after menopause
- Suspected abnormal endometrial cells
- Incomplete miscarriage or complications after miscarriage
*For current miscarriage treatment, dilation and curettage is performed using a vacuum aspiration device called MVA (Manual Vacuum Aspirator), which increases safety and reduces complications such as uterine perforation from curettage - Postpartum hemorrhage
Preparation before dilation and curettage
- If the patient suspects pregnancy, they should inform the doctor
- Inform the doctor if the patient is taking blood thinners, has blood disorders, or has any allergies
- Some patients may need blood tests before the procedure, such as complete blood count or coagulation tests
- Do not eat or drink for about 6–8 hours before the procedure
Treatment procedure
The doctor will insert a duckbill speculum to open the vaginal walls and access the cervix
Then insert a curette, which looks like a spoon, to scrape tissue from the uterine walls
The sample will be sent to the laboratory for further analysis
Post-procedure care
- The patient will rest at the hospital for 2-3 hours
- Nausea and vomiting may occur due to anesthesia or sedative effects
- Rest for 1-2 days after the procedure. The patient can resume normal daily activities but should avoid heavy lifting, using tampons, vaginal douching, or sexual intercourse during the initial period
- Do not soak in bathtubs, rivers, canals, or swimming pools for the first week
- Dilation and curettage may cause changes in the menstrual cycle or cramping in the lower abdomen
- The patient should follow up with the doctor as scheduled
If you experience any of the following symptoms, seek medical attention immediately
- Fever
- Increasing lower abdominal pain lasting more than 48 hours
- Heavy bleeding requiring changing sanitary pads every hour
- Foul-smelling discharge from the vagina
Infections or vaginal bleeding may occur. In some cases, some tissue may remain after dilation and curettage, which the body can expel naturally without harm. However, if infection or increased vaginal bleeding occurs, a repeat dilation and curettage may be necessary.
Women’s Health Center, Phyathai 3 Hospital
