Dilatation and curettage (D & C) is a procedure to remove tissue from inside the uterus. Doctors perform D & C to diagnose and treat certain uterine conditions — such as a heavy bleeding — or to clear the uterine lining after an abortion or miscarriage.

1. PRESENTED BY-
SANDHYA KUMARI
M.SC NURSING
AMITY UNIVERSITY
DIALATATION AND
CURETTAGE

2. INTRODUCTION
Dilation and curettage (D&C) is a procedure in which
material from the inside of the uterus is removed. The
"dilation" refers to dilation of the cervix, the lower part
of the uterus that opens into the vagina.
"Curettage" refers to the scraping or removal of tissue
lining the uterine cavity (endometrium) with a surgical
instrument called a curette. Some curettes are sharp
while others use suction.
Mostly used in first trimester miscarriage or abortion.

3. PURPOSES OF D & C-
 To determine the reason for heavy bleeding during or
between your menstrual periods
 To remove noncancerous tumors, or fibroids
 To remove and examine potentially cancerous tumors
 To remove infected tissue, which is often caused by a
sexually transmitted disease called pelvic inflammatory
disease (PID)
 To remove tissue left behind in the womb after
miscarriage or childbirth
 To perform an elective abortion
 To remove an intrauterine device (IUD), which is a form of
birth control

4. INDICATIONS FOR A DIAGNOSTIC DILATION AND
CURETTAGE INCLUDE THE FOLLOWING:
 Abnormal uterine bleeding
 Irregular bleeding
 Menorrhagia,
 Suspected malignant or premalignant
condition.
 Retained material in the endometrial cavity.

5. CONTRAINDICATIONS TO DILATION AND
CURETTAGE INCLUDE THE FOLLOWING:
 Viable desired intrauterine pregnancy.
 Inability to visualize the cervical os.
 Obstructed vagina.

6. D & C TRAY:-
 Sponge holding-2
 Sims vaginal speculum.
 Sims vaginal wall retractor.
 Cusco`s vaginal speculum.
 Vulsellum forceps 2
 Cervical dilator(Hegar`s dilator).
 Sims uterine curette
 Ayre`s spatula.
 Uterine sounds.

7. PROCEDURE OF D & C
Pre-Operative:-
Instructions to be given to the patient before the
procedure:-
 Limiting food and drink prior 48 hours of the procedure.
 Arrange for someone to help the patient get home
because she may be drowsy after the anesthesia wears
off.
 Clear the schedule to allow enough time for the procedure
and recovery afterward.
 The patient would be spending a few hours in recovery
after the procedure.

8. INTRA-OPERATIVE
During a D&C, the patient lie on her back and place her legs in stirrups
like during a pelvic exam. Then the doctor inserts a speculum into the
vagina and holds the cervix in place with a clamp. Although the D&C
involves no stitches or cuts, the doctor cleanses the cervix with an
antiseptic solution.
D&C involves two main steps:-
Dilation involves widening the opening of the lower part of the cervix to
allow insertion of an instrument. The doctor may insert a slender rod
(laminaria) into the opening beforehand or use a medication before the
procedure to soften the cervix and cause it to widen.
Curettage involves scraping the lining and removing uterine contents with
a long, spoon-shaped instrument (a curette). The doctor may also use a
cannula to suction any remaining contents from the uterus. This can
cause some cramping. A tissue sample then goes to a lab for
examination.

9. CONTD.
Sometimes other procedures are performed
along with a D&C.
For example, The doctor may insert a
hysteroscope to view the inside of the uterus
(called hysteroscopy). He may remove a
polyp or fibroid.

10. POST-OPERATIVE
The patient is sent to recovery room after the D&C for
few hours so that the doctor can monitor heavy
bleeding or other complications. This also gives the
patient time to recover from the effects of anesthesia.
If the patient had general anesthesia, she may
become nauseated or vomit, or might have a sore
throat if a tube was placed in the windpipe to help in
breathing. With general anesthesia or light sedation,
she may also feel drowsy for several hours.

11. SIDE EFFECTS
 Cramping
 Spotting or light bleeding
 Heavy or prolonged bleeding or blood clots
 Fever
 Pain

12. COMPLICATIONS
 Damaged cervix
 Perforated uterus or bladder and blood vessels
 Abdominal tenderness
 Foul-smelling discharge from the vagina
 In very rare cases, scar tissue (adhesions) may
form inside the uterus called Asherman's
syndrome, this may cause infertility and
changes in menstrual flow. Surgery can repair
this problem, so report any abnormal menstrual
changes after a D&C.

13. SUMMARY
 Introduction of D & C
 Purposes of D & C
 Indications of D & C
 Contraindications of D & C
 Articles used in D & C
 Procedure of D & C
 Side Effects of D & C
 Complications of D & C

14. CONCLUSION
Dilation and curettage (D&C) is
a procedure to remove tissue from inside
uterus. Doctors perform dilation and
curettage to diagnose and treat certain
uterine conditions — such as heavy bleeding
— or to clear the uterine lining after a
miscarriage or abortion.

15. THANK
YOU