Dilation and Curettage (D&C): In-depth Overview

Surgical Technique

A D&C involves dilating the cervix to allow access to the uterine cavity. A curette, a specialized instrument, is then used to remove tissue from the uterine lining. This can be performed using various curette types (sharp, blunt, or suction) depending on the specific indication. The procedure can be performed under local or general anesthesia.

Potential Complications

While generally safe, D&C carries potential complications like perforation, infection, hemorrhage, Asherman’s syndrome (intrauterine adhesions), and cervical injury. Careful surgical technique and appropriate patient selection minimize these risks.

Comparing D&C to Alternative Procedures

D&C vs. MVA

Manual Vacuum Aspiration (MVA) is often used for early pregnancy termination or miscarriage management. It employs a manual syringe to aspirate uterine contents. Compared to D&C, MVA is generally less invasive, requires less cervical dilation, and can be performed earlier in gestation. However, D&C might be preferred for incomplete miscarriages or cases requiring a more thorough uterine evaluation.

D&C vs. Hysteroscopy

Hysteroscopy involves visualizing the uterine cavity with a thin, lighted telescope. It can be diagnostic or operative, allowing for targeted biopsies or removal of polyps and fibroids. Hysteroscopy can be combined with D&C for a more comprehensive assessment and treatment. While hysteroscopy offers direct visualization, D&C is sometimes sufficient for simpler procedures.

FAQ: What are the common reasons for performing a D&C?
A D&C can be performed for various reasons, including managing miscarriage or abortion, diagnosing abnormal uterine bleeding, removing retained placental tissue after childbirth, and evaluating endometrial abnormalities.

Case Studies and Clinical Applications of D&C

Case Study 1

A 35-year-old woman presented with heavy and prolonged menstrual bleeding. A D&C was performed to evaluate the endometrium and rule out endometrial hyperplasia or cancer. The pathology report revealed proliferative endometrium, and hormonal therapy was initiated.

Case Study 2

A 28-year-old woman experienced an incomplete miscarriage. A D&C was performed to remove the retained products of conception and prevent complications like infection or hemorrhage.

FAQ: How long does a D&C procedure typically take?
A D&C typically takes 15-30 minutes, but the total time including preparation and recovery can be longer.

FAQ: Is D&C a painful procedure?
Discomfort during and after the procedure is managed with anesthesia and pain medication. Patients may experience mild cramping and spotting for a few days.

FAQ: What is the recovery time like after a D&C?
Most women can resume normal activities within a day or two after a D&C. Strenuous activity should be avoided for a week or as advised by the physician.

Conclusion: D&C remains a valuable procedure in gynecological practice. Understanding its indications, technique, potential complications, and comparison to alternative procedures like MVA and hysteroscopy allows medical professionals to make informed decisions regarding patient care. Further research and clinical experience continue to refine the role of D&C in managing various gynecological conditions.

This article is intended for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment.