D&C stands for dilation and curettage. Dilation refers to the opening of the cervix, and curettage means a sampling of the lining of the uterus. After the cervix is opened, a small instrument that looks kind of like a tiny spoon (a “curette”) is inserted into the uterus and used to scrape cells from the inside surfaces of the uterus. This procedure is often done to get a sample of the lining of the uterus in order to rule out abnormalities or cancer, especially when a biopsy in the office was not possible due to pain or a tightly closed cervix. A D&C is also often done when a woman has had a miscarriage and the contents of the uterus have not emptied on their own. A D&C that is done for a miscarriage is somewhat different from the kind that is done for diagnosis of bleeding abnormalities in that the cervix often has to be dilated more, and suction is often used in conjunction with the curettage to get any remaining pregnancy tissue out of the uterus.
The main risk of this procedure, aside from bleeding or infection, is what is called perforation. When the cervix is dilated open, there is a risk that the dilator can make a hole through the wall of the uterus instead of going through the cervical opening and into the cavity of the uterus where it is intended to go. If a perforation happens, the uterus normally heals itself over with time. If however, there is any concern that the dilator or any other instrument may have passed through the wall of the uterus and injured a structure on the other side of the uterus (like the bowel or the bladder) then we must make an incision on the abdomen to go in and check and correct any damage. This kind of complication happens rarely, but it is important to be aware of it.