Dilation and curettage (D&C)

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Risks

By Mayo Clinic staff

Dilation and curettage is usually very safe, and complications are rare. However, there are risks. These include:

  • Perforation of the uterus. Perforation of the uterus happens when a surgical instrument pokes a hole in the uterus. It happens in up to 1 percent of women overall, but occurs more frequently in women who are pregnant and in older women who have gone through menopause. Most of these tears heal on their own. However, if a blood vessel or other organ is damaged, a second procedure may be necessary to repair it.
  • Damage to the cervix. If the cervix is injured during a D&C, your doctor will treat it by applying pressure or medicine to stop the bleeding, or by suturing a tear.
  • Scar tissue on the uterine wall. In rare cases, a D&C can cause scar tissue in the uterus. This is called Asherman's syndrome and happens most frequently when the procedure is performed after a miscarriage or delivery. This can lead to abnormal or painful menstrual cycles, future miscarriages and infertility. Asherman's syndrome can usually be treated with hormones that encourage growth of healthy uterine tissue, or scar tissue can sometimes be removed with surgery.
  • Infection. Infection after a D&C is possible, but rare.

Contact your doctor if you experience any of the following:

  • Bleeding that is heavy enough that you need to change protection every hour, or if light bleeding lasts longer than two weeks
  • Fever
  • Cramps lasting more than 48 hours
  • Pain that gets worse instead of better
  • Foul-smelling discharge from the vagina
References
  1. Guido RS, et al. Dilation and curettage (D and C). http://www.uptodate.com/home/index.html. Accessed Nov. 3, 2008.
  2. 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.
  3. D&C for uterine bleeding problems. American College of Surgeons. http://www.facs.org/public_info/operation/brochures/dncbleed.pdf. Accessed Nov. 20, 2008.
  4. Dilation and curettage. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp062.cfm. Accessed Nov. 20, 2008.
  5. 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.
  6. 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.
  7. Anesthesia and You. American Society of Anesthesiologists. http://www.asahq.org/patientEducation/anesandyou.htm. Accessed Nov. 28, 2008.
  8. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 5, 2008.

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Jan. 15, 2009

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