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D AND C: WHAT IS IT?

A dilatation and curettage, also called a D and C, is one way to evaluate problems inside the womb. It is a minor surgery performed in a hospital or outpatient surgery center with anesthesia. The opening of the womb, called the cervix, is slowly dilated or opened more to allow a spoon-like or a straw-like instrument into the womb. The lining of the womb is lightly scraped, or curetted, to get a piece of it. This sample of lining is evaluated for disease.

The reasons a D and C may be done include:

• heavy bleeding, as can happen after a birth or with irregular periods

• a large womb

• scarring of the opening of the womb and

• an early pregnancy loss, or miscarriage

Today, an endometrial sampling often replaces the D and C procedure. To perform an endometrial sampling, a sample of the inner layer of the womb wall is removed using a tiny straw-like tube. The test is simple and no anesthesia is needed. Mild pain may occur for a short time after the sample is taken.

This test may be needed for:

• periods that occur too often or are too heavy

• bleeding after menopause

• being unable to get pregnant or

• checking the outcome of a treatment

If an endometrial sampling cannot be done easily and safely in the office, a D and C may be done instead.

These tests have become important as more women are getting care for problems that can now easily be identified. As a result, fewer surgeries are necessary each year.

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