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During the procedure
During a D&C, you receive either general, regional or local anesthesia. You and your doctor will discuss this before the procedure, and the choice will depend on the reason for the D&C and your medical history. In general, if you're having a D&C for pregnancy-related reasons, you receive local anesthesia. Diagnostic D&Cs are usually conducted with general anesthesia.
- General anesthesia. Your doctor gives you an anesthetic through either a breathing mask or an intravenous (IV) catheter. The IV may be placed in a vein in your hand, arm or neck. The anesthetic puts you to sleep during the procedure, so you don't feel any pain. You may have a breathing tube inserted through your mouth and into your windpipe to make sure you're breathing properly. General anesthesia relaxes your muscles, which makes it easier for your doctor to perform a pelvic exam.
- Regional anesthesia. Your doctor injects an anesthetic into the area around your spinal cord. This blocks any pain during the procedure. You may also be sedated from medicine given through an IV.
- Local anesthesia. Your doctor injects an anesthetic directly into and around your cervix to numb the area. You also receive a sedative from an IV.
During the procedure, you lie on your back with your legs in stirrups. Your doctor inserts a speculum into your vagina, as in a pelvic exam, in order to see your cervix. Your doctor then slowly dilates your cervix by inserting a series of thicker and thicker rods into your cervix until it's adequately opened, usually to between 6 and 9 millimeters in diameter. Your doctor then inserts the curette and begins removing tissue. Because you're either asleep or sedated during this, you shouldn't feel any discomfort. A D&C usually takes about 15 to 30 minutes.
After the procedure
You spend a few hours in a recovery room after the D&C so that your doctor can monitor you for vaginal bleeding or other complications. This also gives you time to start recovering from the anesthesia.
If you had general anesthesia, you may:
- Become nauseous
- Vomit
- Have a sore throat if a tube was inserted into your windpipe to help you breathe
If you received general anesthesia or IV sedation, you may be drowsy for several hours.
Other normal side effects of a D&C may last a few days and include:
- Mild cramping
- Spotting or light bleeding
Cramping can be treated with medication like ibuprofen (Advil, Motrin, others).
It's important not to put anything in your vagina until your cervix returns to its normal size. This is because bacteria can enter your uterus while your cervix is dilated and cause an infection. Ask your doctor when you can have sex or use tampons again.
If you had a D&C because of a miscarriage, talk with your doctor about when it's safe to begin trying to become pregnant again.
Your uterus must build a new lining after a D&C, so your next period may not come on time.
- Guido RS, et al. Dilation and curettage (D and C). http://www.uptodate.com/home/index.html. Accessed Nov. 3, 2008.
- Sharp HT. Endometrial sampling/dilatation and curettage. In: Adams Hillard PJ, ed. 5-Minute Obstetrics and Gynecology Consult. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008. http://www.5minobgyn.com/pt/re/hillard/bookcontent.01337302-1st_Edition-4.htm;jsessionid=JH3LLTpmphX94DCXFVfGLXfnhsjS1Dz6WCLWLV2QLhH0kvhrJJHY!-26702612!181195628!8091!-1?index=1&database=books&results=1&count=10&searchid=2&nav=search&cursorname=S.sh.42.43&fieldname=compref&recordnum=1&xpath=/bookdb/01337302/1st_Edition/4/WO(244137)&endxpath=/bookdb/01337302/1st_Edition/4/WO(244182)#gohere. Accessed Nov. 25, 2008.
- D&C for uterine bleeding problems. American College of Surgeons. http://www.facs.org/public_info/operation/brochures/dncbleed.pdf. Accessed Nov. 20, 2008.
- Dilation and curettage. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp062.cfm. Accessed Nov. 20, 2008.
- Early pregnancy loss: Miscarriage and molar pregnancy. The American College of Ostetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp090.cfm. Accessed Nov. 24, 2008.
- Wieslander CK, et al. Therapeutic gynecologic procedures. In: DeCherney AH, et al. Current Diagnosis & Treatment Obstetrics & Gynecology. 10th ed. Columbus, Ohio: The McGraw-Hill Companies; 2007. http://www.accessmedicine.com/content.aspx?aid=2391387. Accessed Nov. 25, 2008.
- Anesthesia and You. American Society of Anesthesiologists. http://www.asahq.org/patientEducation/anesandyou.htm. Accessed Nov. 28, 2008.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 5, 2008.
