D&C Definition, Risks, and Patient Experiences

Definition

D&C stands for Dilatation and Curettage. This is a surgical procedure that involves dilating the cervical canal, by enlarging the opening of the uterus. Once the cervix is dilated, the surgeon uses a spoon shaped instrument – called a curette – to scrape the walls of the uterus. For the most comprehensive information about D&Cs and Asherman's Syndrome, please click here to visit DandCnow.info.

Medical Definition

Dilatation – 1. the condition, as of an orifice or tubular structure, of being dilated or stretched beyond normal dimensions. 2. the act of dilating or stretching *

Dilatation and curettage – expanding of the ostium uteri to permit scraping of the walls of the uterus; called also D and C. *

Curettage – the removal of growths or other material from the walls of a cavity, as with a curet; called also a curettement. **

* B. F. Miller and C. B. Keane.Encyclopedia and dictionary of medicine, nursing and allied health. Second Edition. Philadelphia: Saunders, 1987 
** Dorland's illustrated medical dictionary. 28th Edition. Philadelphia: Saunders, 1994.

Risks of D&C

With any medical procedure, there are risks, and these should be weighed and compared against the risks and benefits of the other treatment options as you discuss them with your doctor. Potential complications of a D&C include hemorrhage, infection, perforated uterus, Asherman's Syndrome (scarring inside the uterus), and irregular periods and/or difficulty conceiving.

There is a 25% risk of developing Asherman?s Syndrome from a D&C that is performed 2 to 4 weeks after delivery (5-8). Dilation and curettages may also lead to Asherman?s Syndrome in 30.9% of procedures for missed miscarriages and 6.4% of procedures for incomplete miscarriages (2). The risk of Asherman?s Syndrome increases with the number of D&Cs performed; after a single termination the risk is 16% however, after 3 or more D&Cs, the risk increases to 32% (9). Each case of Asherman's Syndrome is different, and the cause must be determined on a case-by-case basis. In some cases, Asherman's Syndrome may have been caused by an "overly aggressive" D&C. However, this is not often considered to be the case. The placenta may have attached very deeply in the endometrium or fibrotic activity of retained products of conception could have occurred, both of which make it difficult to remove retained tissue without causing injury to the basal endometrium. For the most comprehensive information about D&Cs and Asherman's Syndrome, please click here to visit DandCnow.info.

Patient experiences of D&C

First Experience:

1. Did you have to do anything prior to the procedure?
“Fasting (12hrs)-just like any other surgery.”

2. Was the procedure performed at a hospital?
“Yes”

3. Was it a day procedure or did you need to stay in the hospital?
“Outpatient procedure - total time for prep, surgery and recovery was at most 4 hours”

4. How long did the procedure last?
“Actual surgery was 10 minutes (I believe--I was out, but that is what I remember being told)”

5. What did happen immediately afterwards?
“Woke up in recovery room - after I seemed conscious enough, they moved me to a private room for recovery--it took me a while to totally wake up. I felt fine, and they sent me home.” 

6. Did you experience any reactions after the procedure? Pains?
“No. Completely painless.”

7. Did you have to do or avoid anything specific after the procedure?
“I don't remember, but think we were supposed to avoid sex for a few days.”

8. Did you need to stop your daily routine/ or take days off from work? How many days did you take?
“I was not working that day anyway, but for a woman with a full-time job, she would probably want to take that full day off from work.”

Additional info:
“The procedure was so easy and so painless, I wondered why I'd had any fear at all. I really felt great immediately afterwards, since I'd been feeling nauseous etc from the retained products of conception. Of course I had no idea that would be the cause of my Asherman's Syndrome, but truly at the time I felt terrific.”

Second Experience: 

“Emergency D&C - in and out same day local hospital - I was on maternity leave, but it was a good couple of weeks before I felt fit and well again. I was also restricted about exercise as it happened quickly after the birth of my daughter and so was unable to exercise anyway.”

Third Experience: 

Here is my experience mostly re. first d&c. One due to a "missed miscarriage" and the other due to a retained placenta one month after the delivery of my daughter.”

“Both d&c's were performed at the hospital and was under general anaesthesia. The first time I had a d&c it was very emotional and I didn't take any time to heal physically or emotionally. I had the d&c and went home within twenty minutes of waking up. After I got home I threw up several times and the pain was unbearable. I had to go back to the emergency room and they finally admitted me. The administered pain medication via IV. This was COMPLETELY AVOIDABLE. The thing to remember is you should not be discharged from the hospital unless you can go to the bathroom first. Something so simple, but with such horrible side effects. Your intestines basically go to sleep after general anaesthesia and by going to the bathroom it demonstrates that things are now in working order. I threw up all pain medication. So the reason I write this is to make sure you insist on going to the bathroom while you are at the hospital.” 

“I was moving around that night and didn't take much time to heal. I haemorrhaged throughout the week and finally fairly significant blood loss came at the end of a week. After that I was fine. I think I overdid it.”

“Emotionally I listened to all the people about it being not a big deal. It hurts emotionally. It is a big deal. Take time to grieve. If you don't do it now you will eventually....”

Forth Experience: 

“D&C - This was done by my OB/GYN at local hospital as outpatient surgery, so it did not require a hospital stay. The only preparation I recall, is that I could not eat or drink anything after midnight, before the surgery. I think I may have had to take an antibiotic afterwards, but I don’t recall now. I had the surgery on a Monday, and went back to work on Wed. I think I had bleeding like a heavy period, but no pain. No reactions from the anaesthesia (was not awake for the whole procedure).”

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