D&C for Miscarriage

What is a D&C?
D and C - also known as dilatation (dil-ah-tay'-shun) and curettage (koo-re-tahzh') - is a minor surgical procedure in which the physician first dilates or opens the woman's cervix and then inserts a thin, spoon-shaped instrument and uses it to remove material from the internal lining of the uterus. Dilatation, therefore, stands for opening the cervix; curettage means the scraping of the uterine wall.

D&C is one of the most common surgical procedures of all. However, as routine as a D&C is, no two women undergoing a D&C are alike. The reasons for and the outcome of any operation depend on your overall health, your age, the severity of uterine bleeding, and any other abnormalities that exist in your uterus, such as polyps.

About the Procedure
A D&C procedure for a miscarriage is usually done on an outpatient basis in either a hospital or freestanding surgery center. An intravenous line (IV) will be started before you enter the operating room. Once you are asleep under anesthesia, the following will take place:

• You will be positioned on your back on a gynecological table; your knees will be bent and your feet will be in stirrups. At this time, the surgeon will pass a series of dilators into the vagina and the cervix, gradually opening the strongly contracted muscles of the cervix.
• When the cervix is sufficiently opened, the surgeon will insert a curette, a sharp-edged loop that is used to scrape the lining of the uterus, into the uterus. Tissue and specimens are removed and examined by the doctor and are sent to a pathology lab for evaluation.
• A nurse will then put a sanitary napkin in place before you are taken to the recovery room. The operation takes about 30 minutes. You will be in the recovery room for about 40 minutes.
• Bleeding during the procedure is usually minimal, but occasional transfusions are necessary. Your surgeon will discuss this with you prior to the procedure.

After the Procedure
In most cases, you will be discharged from the surgery center or hospital on the same day that your D&C is done.

The results of the laboratory evaluation of the removed tissue will be available at your post-operative visit. At that time, your doctor will recommend treatment for conditions that are identified by the procedure. You will be encouraged to walk to the bathroom and resume normal non-strenuous activity as soon as you are comfortable doing so. Expect slight bleeding and staining for anywhere from five to 14 days following your D&C. You should refrain from sexual intercourse, douching and the use of tampons for at least two weeks. Use sanitary napkins during this time.

Following the D&C, you will be given oral medication for any postoperative pain, such as cramps. Most pain disappears within 24 hours. You also may be given an antibiotic to prevent infection. A D&C procedure that is performed following miscarriage leaves no scar. If your occupation does not involve heavy physical work, you can plan on returning to your job in two days. Your doctor will talk to you about when you can again become pregnant if that is what you desire.