Dilatation and curettage

Preethi has just seen her gynaecologist for abnormal bleeding from the uterus. She has been advised a D&C. She has heard the term before and she knows that it is a common procedure. Her gynaecologist has told her that it is a minor surgical procedure but she is still a little apprehensive.

What is a D&C?

Dilatation and curettage (D&C) is a procedure used to diagnose or treat abnormal bleeding from the uterus. In younger women, a D&C is usually done to detect hormone imbalances by examining the lining of the uterus. In older women, it can be used to help detect cancer of the uterus.

Dilating the mouth of the uterus makes it easier to access the cavity of the uterus. Curettage involves removing a sample of the lining of the uterus for further examination.

Why is a D&C done?

Diagnostic D&C:

A D&C may be done to diagnose conditions that could cause abnormal bleeding. It provides a sample of the tissue in the uterus. This sample can be viewed under a microscope to tell whether the cells are normal or abnormal. This kind of D&C is called a diagnostic D&C. It is usually done for:

Menstrual abnormalities

Menstrual periods can be irregular at certain times of life. From the age of 35 to 45, most women will have an occasional irregular period. Some women may have very heavy periods. As women approach the age of 50, their periods may become irregular as they near menopause. There may also be bleeding between periods. A hormone imbalance can cause the lining of the uterus (endometrium) to thicken more than usual. This could explai heavier or longer bleeding.

If your gynaecologist has given you medications and still there is no change in the periods, then a D&C may be recommended. Usually an ultrasound will be done before a D&C to rule out an abnormality in the uterus like a polyp or a fibroid which may be causing the bleeding.