Dilatation and Curettage (D&C)

Dilatation and Curettage (D&C) is a gynecological procedure where the cervix is dilated and the endometrium (refer uterus in female reproductive system) is scraped by a curette (a metal instrument). D&C is not only used in performing abortion, it is also done in:

• evacuating any products of conception that may remain in the uterine cavity in miscarriage, and
• the diagnosis of abnormal vaginal bleeding to exclude any pathology in the uterine cavity.

The procedure is usually carried out under general anesthesia and usually takes about 15-20 minutes. Occasionally, the procedure can be done under regional anesthesia or under sedation. The cervix is first dilated with metal rods (dilators). After it has been dilated adequately, a sharp metal instrument called a curette is inserted into the uterus and the lining of the uterus is gently scraped systematically and the tissues obtained are sent to the pathologist for microscopic examination.

Nowadays, D&C is gradually replaced by endoscopic examination using hysteroscope. Hysteroscopy is a procedure where a thin telescope is passed into the uterine cavity and the lining of the uterus or endometrium is viewed under direct vision using a camera system. Various pathology such as endometrial polyp, fibroid or cancer, can be visualized and the lesion removed and/or biopsy taken under direct vision.