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What to expect during a D&C (Dilation and Curettage) procedure

Although it sounds scary, Dilation and Curettage or D&C is a minor surgical procedure with big benefits.

Your uterus is an important organ that, apart from creating and holding a human baby, provides support and structure to your bladder, bowels and pelvic bones. While it may be resilient, sometimes, it may need some extra help, following some changes that happen in the uterine environment. For which, your gynaecologist may have prescribed you a D&C procedure. Many women may not have heard of D&C, until it is recommended by their doctor. It's normal to be confused about what the process entails, especially since it concerns your health. Here is a complete low down about the procedure so you know exactly what to expect when you are scheduled for a D&C.

What is D&C?

D&C stands for Dilation and Curettage, a minor surgical procedure carried out of gynaecologists to resolve certain uterine problems. Dilation or dilatation is the widening of the cervix a special instrument and curettage is the scraping of the inner lining of the uterus. Sometimes, the same procedure also involves sucking out the uterine contents through vacuum aspiration instead of curettage.

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Dr Bandita Sinha, Gynaecologist and fertility specialist, Director, World of Women, Vashi, Mumbai explains that there are two types of D&C procedures. First is Diagnostic D&C performed under three conditions.

If the uterine bleeding is abnormal.

If the bleeding is after menopause.

If the doctor suspects malignancy.

(Read: 10 common signs and symptoms of cancer)

"If the patient shows signs of abnormal bleeding from the uterus, we have to check for malignancies. For this, we perform diagnostic D&C to detect intrauterine and endometrial abnormalities. After the lining is scraped, we send the tissues for a biopsy to determine the cause of the bleeding. The lab will then find out whether the cause is hormonal or malignant."

(Read: 7 reasons why you have prolonged periods)

The second is therapeutic D&C where the doctor performs the procedure for as a curative measure if the patient suffers from:

Abnormal thickening of the endometrial lining

Uterine polyps or fibroids

Uterine cancer

Molar pregnancy

Post-delivery bleeding

Miscarriages or abortions

Pelvic inflammation

Neoplasms

Ectopic pregnancy

"The retained products in the uterus following a miscarriage can cause infection inside. So in order to remove the remnants completely, the gynaecologist may prescribe a D&C procedure," says Dr Sinha.

"Usually, it is performed on married and sexually active women. Rarely do we recommend the procedure for women under the age of 20," she adds.

How is D&C performed?

"D&C is a day care procedure performed by giving the patient general anaesthesia," says Dr Sinha. The patient is prepped with antibiotics before and after the procedure to quell any chances of an inflammation. "The patient is also advised to go on a fast for four to five hours before the treatment," she says.

Dilators are inserted into the cervix to widen the passage so that the curettage instruments can pass through it. Afterwards, a curette or a sharp surgical instrument is used to scrape out the lining. In case of vacuum aspiration, a suction device is inserted into the uterus instead of the curettage to vacuum out the contents. "After the procedure, the patient is advised to take rest for the entire day. She can get back to work the very next day. In some cases, patients may experience minor cramping for a while afterwards," says Dr Sinha.

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