Dilation and Curettage (D & C)

What is a dilation and curettage (D&C)?

A dilation and curettage (or D&C) is a procedure to remove tissue from your uterus. A gynecologist or obstetrician performs this surgery in their office, hospital or a surgical center. It’s usually an outpatient procedure, so you go home the same day.

A D&C gets its name from:

• Dilation of the cervix: Your healthcare provider dilates, or opens, your cervix. Your cervix is the opening of your uterus, where it meets the top of your vagina. Usually, your cervix only dilates during childbirth.
• Curette: Your provider uses a thin instrument called a curette to scrape your uterine wall and remove tissue.

Why would a person need a D&C?

Healthcare providers may perform a D&C for several reasons, such as:

• Removing tissue from your uterus. This can happen after a miscarriage, abortion or when parts of the placenta are left in your uterus after childbirth. Your uterus needs to be completely empty after any of these events due to an increased risk of infection and bleeding.
• Diagnosing or treating irregular uterine bleeding. A D&C can remove the abnormal tissue that causes medical conditions like infection, fibroids or uterine cancer. It can also remove a cyst, polyp or tumor. Your provider may send a sample of your uterine tissue to a lab for analysis (biopsy).

Sometimes, you have a D&C and hysteroscopy. During this procedure, your provider inserts a video-like device into your cervix to see the inside of your uterus. You may have a hysteroscopy with a D&C if your provider is trying to diagnose a medical condition.

What happens before a dilation and curettage (D&C)?

Your healthcare provider will take a full medical history before a D&C. You should make sure they know what medications you take or about any allergies you have. Be sure to tell them if you suspect you’re pregnant. They may ask you to stop eating and drinking beginning the evening before a D&C.

Healthcare providers may recommend medication to soften and dilate (widen) your cervix before a D&C either by using a laminaria stick or by giving you a medication called misoprostol.

What happens during a dilation and curettage (D&C)?

Before the procedure, your provider will go over options for anesthesia with you. Your provider will recommend the best anesthesia option for you based on your medical history and why you’re having the procedure.

There are several options for anesthesia during a D&C:

• General anesthesia, where you’re asleep for the procedure.
• Regional anesthesia (like an epidural), which means you won’t have feeling from your waist down. You’re fully conscious with this type of anesthesia.
• Local anesthesia, which means only your cervix is numb. You’re awake and have feeling in all areas of your body other than your genital area.

After you receive anesthesia, your provider will begin the procedure. The steps of a D&C generally go like this:

• You lie on a table with your feet in stirrups, like during a gynecologic exam.
• Your healthcare provider inserts a speculum into your vagina. This device, shaped like a duck’s bill, helps open your cervix. A clamp helps hold your cervix in place.
• Your provider will use dilators, which are thin metal rods that start small and then gradually increase in diameter. The rods gently stretch your cervix until it’s wide enough to accommodate the instruments your provider needs to complete the procedure.
• Your provider uses a curette, a type of spoon-shaped scraping device, to clean out the tissue from your uterus. They sometimes use a thin suction device to get any remaining tissue.
• They may send a sample of the tissue to a lab for analysis.

How long does a dilation and curettage (D&C) take?

The procedure itself takes about five to 10 minutes. But the entire process takes longer due to receiving anesthesia and other preparations. You’ll also need to wait in the recovery room for a few hours after the procedure before you go home.

Is having a D&C painful?

You may feel cramps similar to menstrual cramps after a D&C. Over-the-counter (OTC) pain medication like acetaminophen (Tylenol®) can relieve the cramps.

Are you put to sleep for a D&C?

Maybe. It depends on your health history and the reason you’re having a D&C. Not everyone receives general anesthesia.

What happens after this procedure?

You’ll need someone to drive you home from the procedure. It’s normal to experience mild cramping and light bleeding (or spotting) for a few days after a D&C.

Use pads, not tampons, for the bleeding. Don’t begin having sex again until your healthcare provider tells you it’s safe to do so (usually about one week after the procedure). Until your cervix closes and returns to its normal size, you’re at a higher risk of bacteria entering your vagina and causing an infection. Your provider will tell you when you can resume having sex and using tampons.

You should be able to get back to your regular activities after a few days.

If your provider sent a sample of tissue for analysis, you can expect results within a week. Ask your healthcare provider about when and how you may receive biopsy results.

You usually have a follow-up visit with your healthcare provider within two weeks.

What are the advantages of a dilation and curettage (D&C)?

A D&C can help your provider figure out why you have abnormal bleeding. It can also help detect abnormal endometrial cells, which may be a sign of uterine cancer. After a D&C, your provider sends the sample of cells to a laboratory where pathologists can identify if you have normal or abnormal tissue, polyps or cancer.

A D&C may also be important for your health after a miscarriage or abortion. It removes any leftover tissue to prevent heavy bleeding and infection.

What are the risks of a dilation and curettage (D&C)?

A D&C is a safe, routine procedure. But like any surgery, it has some risks. D&C risks include:

• Uterine perforation (a small tear in your uterus), which may happen if one of the surgical instruments passes through your uterine wall.
• Infection.
• Bleeding.

In rare cases, if you had a D&C after a miscarriage, you may develop Asherman’s syndrome. This condition occurs when adhesions, or bands of scar tissue, form in your uterus. This condition can cause infertility and change your menstrual flow. This condition is treatable with a minor surgery to remove the adhesions.

What is the recovery time from a D&C?

The exact recovery time varies, but most people can return to their normal activities within five days or fewer. Depending on the reason for a D&C, the emotional recovery may be much longer. For example, if you had a D&C due to a miscarriage, it may take much longer to cope with the feelings of loss and heal emotionally.

Will a D&C affect my menstrual cycle?

After having a D&C, your next period may be early or late. This is because it’s unknown how long it’ll take for your uterine lining to build back up.

If you had a D&C due to a miscarriage, talk to your provider about when it’s safe to resume trying to get pregnant again. In some cases, your provider will want you to have at least two or three menstrual cycles before trying to conceive.

When should I call my healthcare provider about a dilation and curettage (D&C)?

Complications from a D&C are treatable when they’re diagnosed early. If you notice symptoms after a D&C, call your provider so they can help you. Symptoms may include:

• Tender or painful belly.
• Fever.
• Heavy bleeding.
• Large blood clots coming from your vagina.
• Severe abdominal cramps.
• Unusual or foul-smelling vaginal discharge.

If I had a miscarriage, do I need a dilation and curettage (D&C)?

Up to 50% of people who miscarry don’t need a D&C procedure. If the miscarriage occurs before 10 weeks of pregnancy, it’ll most likely happen on its own (natural miscarriage). After the 10th week of pregnancy, there’s a higher risk of having an incomplete miscarriage. In that case, you may need a D&C procedure to make sure your uterus is completely empty.

At what stage of pregnancy do people get a D&C?

There are many factors that go into determining when or if a person needs a D&C. The decision to have a D&C for any reason is a personal choice and one that is best made after talking to your healthcare provider.

A D&C may be an option to end a pregnancy in the first trimester (up to about 13 weeks of pregnancy).

A note from Cleveland Clinic

A D&C, or dilation and curettage, is a procedure to remove tissue from your uterus. Your healthcare provider can use a D&C and hysteroscopy to diagnose unexplained bleeding. So, it may help your provider find answers you’ve sought for a long time. Or it may be the last step after an incomplete miscarriage or abortion. If you had a miscarriage or have bleeding between your periods, talk to your healthcare provider to see if you need a D&C.