Overview
Dilation and Curettage (D&C) is a surgical procedure used to dilate the cervix and scrape the uterine lining. It is performed for diagnostic and therapeutic purposes.
D&C is crucial for treating incomplete abortion, abnormal uterine bleeding, and obtaining endometrial tissue for histological examination.
Learn more in our comprehensive RxDx OBG Course
Indications
Retained products of conception
Heavy or irregular bleeding
Diagnostic evaluation
Evaluation of bleeding
Evacuation of molar tissue
Contraindications
Absolute Contraindications
Relative Contraindications
📋 Equipment Checklist
Check off items as you gather them:
Pre-procedure Preparation
Preparation includes patient consent, anesthesia, sterile technique, and proper positioning. All equipment should be ready.Step-by-Step Procedure
Step 1: Patient Preparation
Explain procedure, obtain consent, position patient.
⚠️ Common Mistakes to Avoid:
- Inadequate consent
- Poor positioning
💡 Pro Tip:
Position patient in lithotomy position.
Step 2: Anesthesia
Administer local or general anesthesia.
⚠️ Common Mistakes to Avoid:
- Inadequate anesthesia
- Wrong type
💡 Pro Tip:
Use appropriate anesthesia.
Step 3: Cervical Dilation
Dilate cervix gradually.
⚠️ Common Mistakes to Avoid:
- Too rapid dilation
- Cervical trauma
💡 Pro Tip:
Dilate gradually to avoid trauma.
Step 4: Curettage
Scrape uterine cavity systematically.
⚠️ Common Mistakes to Avoid:
- Incomplete curettage
- Uterine perforation
💡 Pro Tip:
Curette systematically.
Step 5: Tissue Removal
Remove all tissue and clots.
⚠️ Common Mistakes to Avoid:
- Incomplete removal
- Retained tissue
💡 Pro Tip:
Ensure complete evacuation.
Step 6: Hemostasis
Ensure adequate hemostasis.
⚠️ Common Mistakes to Avoid:
- Bleeding
- Hematoma
💡 Pro Tip:
Check for bleeding before completion.
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Post-procedure Care
Post-procedure care involves monitoring for complications, pain management, and patient education.Complications & Management
| Complication | Incidence | Signs | Management | Prevention |
|---|---|---|---|---|
| Uterine perforation | 1-3% | Abdominal pain, bleeding | Laparoscopy, observation | Gentle technique |
| Cervical trauma | 2-5% | Cervical bleeding | Suturing, pressure | Gradual dilation |
| Infection | 3-8% | Fever, foul discharge | Antibiotics | Sterile technique |
| Asherman syndrome | 1-2% | Amenorrhea, infertility | Hysteroscopy, lysis | Gentle curettage |
Clinical Pearls
Dilate cervix gradually to avoid trauma.
Curette systematically in all quadrants.
Ensure complete evacuation of tissue.
Check for uterine perforation.
Use sterile technique throughout.
Document all findings carefully.
Monitor for complications post-procedure.