DILATATION &
CURETTAGE
DILATATION &CURETTAGE
•Dilatation and Curettage (D&C) is a
gynaecological procedure in which the
cervix is dilated and the lining of uterus
(endometrium) is scraped away.
INDICATIONS:
•D&C may be :
1. Diagnostic
2. Therapeutic
DIAGNOSTIC:
Sample of endometrium is taken and sent for
histopathological examination.
CONDITIONS:
1. Abnormal uterine bleeding
2. Uterine polyps
3. Endometrial hyperplasia
4. Endometrial carcinoma
THERAPEUTIC:
• Molar pregnancy
• To clear out retained placenta after delivery to
limit bleeding
• Clearing out RPOC after miscarriage or abortion
• Removal of cervical or uterine polyps
D&C TRAY:
• Sponge holders
• Sims vaginal speculum
• Valsellum forceps
• Uterine sound
• Cervical dilator (Hegar’s dilator)
• Uterine curette
• Metallic urinary catheter
SPONGE HOLDING FORCEPS
METALLIC URINARY CATHETER
SIMS SPECULUM
VALSELLUM FORCEPS
UTERINE SOUND
HEGAR’S DILATOR
UTERINE CURETTE
PROCEDURE:
1. Proper Anasthesis i.e General, Local or
epidural
2. Lithotomy position
3. Exposure, cleaning and painting the pelvic
area.
4. Empty the bladder via metallic catheter.
5. Bimanual examination to examine the cervix
and uterus
6. Insert Sims speculum to retract vaginal walls.
7. Use Valsellum to retract anterior cervical
lip.
8. Enter uterine sound to measure the length
of uterus.
9. Use Hegar’s dialtor to dilate cervix
10. Use curette for curettage untill grating
sound appear or bubble formation occurs.
COMPLICATIONS:
• Bleeding
• Increased risk of Infections
• Asherman’s Syndrome: extensive Scraping result
in excessive scaring leading to infertility and
failure to menstruate
• Foul smelling vaginal discharge
• Risk of trauma to vulva and vagina
• Risk of perforation
DIAGRAMATIC
REPRESENTATION
INSERTING
DILATOR:
CURETTE
INSERTION
AND SAMPLE
TAKING