Dilation (dilatation) and curettage literally refers to the dilation (opening) of the cervix and surgical removal of the contents of the uterus. It is a therapeutic gynecological procedure as well as a rarely used method of first trimester abortion.^[1][2] It is commonly referred to as a D&C. Gestational age is age of a fetus (or newborn infant) from presumed conception. ... Cervical dilation is the dilation (widening) of the cervix during childbirth. ... Schematic frontal view of female anatomy The cervix (from Latin neck) is the lower, narrow portion of the uterus where it joins with the top end of the vagina. ... The uterus or womb is the major female reproductive organ of most mammals, including humans. ... The shamefulness associated with the examination of female genitalia has long inhibited the science of gynaecology. ...

D&C normally refers to a procedure involving a curette, also called sharp curettage.^[1] However, some sources use the term D&C to refer more generally to any procedure that involves the processes of dilation and removal of uterine contents, which includes the more common suction curettage procedures of manual and electric vacuum aspiration.^[3] Noun A spoon-shaped surgical instrument for cleaning a diseased surface. ... Vacuum or suction aspiration abortion is a form of abortion using aspiration. ...

Procedure

The first step in a D&C is to dilate the cervix, usually done a few hours before the surgery. The woman is usually put under general anesthesia before the procedure begins. A curette, a metal rod with a handle on one end and a sharp loop on the other, is inserted into the uterus through the dilated cervix. The curette is used to gently scrape the lining of the uterus and remove the tissue in the uterus. This tissue is examined for completeness (in the case of abortion or miscarriage treatment) or pathologically for abnormalities (in the case of treatment for abnormal bleeding).!!!^[1] Schematic frontal view of female anatomy The cervix (from Latin neck) is the lower, narrow portion of the uterus where it joins with the top end of the vagina. ... This article or section may be confusing for some readers, and should be edited to be clearer. ... Noun A spoon-shaped surgical instrument for cleaning a diseased surface. ...

Clinical uses

D&Cs are commonly performed to resolve abnormal uterine bleeding (too much, too often or too heavy a menstrual flow);^[2] to remove the excess uterine lining in women who have conditions such as PCOS (which cause a prolonged buildup of tissue with no natural period to remove it);^{[citation needed]} to remove tissue in the uterus that may be causing abnormal vaginal bleeding;^[1] to remove retained tissue (also known as retained POC or retained products of conception) in the case of an incomplete miscarriage;^[3] and historically, as a method of abortion that is now uncommon.^[1] The menstrual cycle is the periodic change in a womans body that occurs every month between puberty and menopause and that relates to reproduction. ... Polycystic ovary syndrome (PCOS, also known clinically as Stein-Leventhal syndrome), is an endocrine disorder that affects 5–10% of women. ... Miscarriage or spontaneous abortion is the natural or accidental termination of a pregnancy at a stage where the embryo or the fetus is incapable of surviving, generally defined at a gestation of prior to 20 weeks. ...

Vacuum or suction aspiration abortion is a form of abortion using aspiration. ... Dilation and evacuation is a form of abortion using dilation and evacuation. ... Intact dilation and extraction (IDX or intact D&X), also known as intact dilation and evacuation (intact D&E), dilation and extraction (D&X), intrauterine cranial decompression and controversially in the United States as partial birth abortion), is a surgical abortion wherein an intact fetus is removed from the womb... Hysterotomy abortion is a form of abortion, similar to a caesarian abortion. ... Instillation abortion is a method of induced abortion used between 16th and 24th week of pregnancy. ... Menstrual extraction is both a surgical abortion method and a menstrual hygiene technique, by which either an entire menstrual period may be removed in a few minutes, or a blastocyst or small embryo--without confirmation of pregnancy. ... Abortion, in its most common usage, refers to the voluntary or induced termination of a pregnancy, generally through the use of surgical procedures or drugs. ... Spontaneous: Miscarriage Debate & social issues Breast cancer · Crime effect Crisis pregnancy centers Fetal pain · Religion · Mental health Pro-choice · Pro-life Selective abortion and infanticide Unsafe abortion · Violence History of abortion This box:      Mifepristone is a synthetic steroid compound used as a pharmaceutical. ... Misoprostol is a drug that is United States Food and Drug Administration (FDA)-approved for the treatment and prevention of stomach ulcers. ...

Abortion

Because medical and non-invasive methods of abortion now exist, and because D&C requires heavy sedation or general anesthesia and has higher risks of complication, the procedure has been declining as a method of abortion. The World Health Organization recommends D&C as a method of abortion only when manual vacuum aspiration is unavailable.^[4] According to the Centers for Disease Control and Prevention, D&C only accounted for 2.4% of abortions in the United States in the year 2002,^[5] down from 23.4% in 1972.^[6] The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. ... Vacuum or suction aspiration abortion is a form of abortion using aspiration. ... The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ... For album titles with the same name, see 2002 (album). ... Year 1972 (MCMLXXII) was a leap year starting on Saturday (link will display full calendar) of the Gregorian calendar. ...

Complications

If the procedure is performed too roughly, scar tissue may form and seal the uterus shut (Asherman's syndrome), resulting in infertility. Another consequence of excessively forceful technique is uterine perforation. Although normally no treatment is required for uterine perforation, a laparoscopy may be done to verify that bleeding has stopped on its own. Infection of the uterus or fallopian tubes is also a possible complication, especially if the woman has an untreated sexually transmitted infection.^[1] Ashermans syndrome , also called uterine synechiae, presents a condition characterized by the presence of scars within the uterine cavity. ... Infertility primarily refers to the biological inability of a man or a woman to contribute to conception. ... The uterus or womb is the major female reproductive organ of most mammals, including humans. ... Laparoscopic surgery, also called keyhole surgery (when natural body openings are not used), bandaid surgery, or minimally invasive surgery (MIS), is a surgical technique. ... Sexually-transmitted infections (STIs), also known as sexually-transmitted diseases (STDs), are diseases that are commonly transmitted between partners through some form of sexual activity, most commonly vaginal intercourse, oral sex, or anal sex. ...

Having two or more sharp curettage procedures may increase the risk of complications in future pregnancies, such as ectopic pregnancy, miscarriage, and placenta previa.^[1] Miscarriage or spontaneous abortion is the natural or accidental termination of a pregnancy at a stage where the embryo or the fetus is incapable of surviving, generally defined at a gestation of prior to 20 weeks. ... Placenta praevia (placenta previa AE) is a obstetric complication that can occur in the second or third trimester of pregnancy. ...

See also

• Dilation and evacuation
• Menstrual extraction
• Vacuum aspiration

Dilation and evacuation is a form of abortion using dilation and evacuation. ... Menstrual extraction is both a surgical abortion method and a menstrual hygiene technique, by which either an entire menstrual period may be removed in a few minutes, or a blastocyst or small embryo--without confirmation of pregnancy. ... Vacuum or suction aspiration abortion is a form of abortion using aspiration. ...

References

1. ^ ^{a b c d e f g} Dilation and sharp curettage (D&C) for abortion. Healthwise. WebMD (2004-10-07). Retrieved on 2007-04-29.
2. ^ ^{a b} Hayden, Merrill (2006-02-22). Dilation and curettage (D&C) for dysfunctional uterine bleeding. Healthwise. WebMD. Retrieved on 2007-04-29.
   Nissl, Jan (2005-01-18). Dilation and curettage (D&C) for bleeding during menopause. Healthwise. WebMD. Retrieved on 2007-04-29.
3. ^ ^{a b} What Every Pregnant Woman Needs to Know About Pregnancy Loss and Neonatal Death. The Unofficial Guide to Having a Baby. WebMD (2004-10-07). Retrieved on 2007-04-29.
4. ^ Dilatation and curettage. A-Z Managing Complications in Pregnancy and Childbirth by WHO. Retrieved on February 20, 2006.
5. ^ Abortion Surveillance --- United States, 2002. MMWR Surveillance Summaries. Retrieved on February 20, 2006.
6. ^ Abortion Surveillance -- United States, 1990. MMWR Surveillance Summaries. Retrieved on February 20, 2006.