Dilation and curettage refer to a process in which the cervix is expanded and a sharp curette is introduced into through the vaginal opening to scrape out the contents of the uterus. It is a surgical procedure that is recommended only if the option of manual vacuum aspiration is unavailable.
The most common reason for conducting dilation and curettage is abortion, though the procedure is now losing some of the popularity it used to enjoy earlier. Dilation and curettage for miscarriage is also recommended if the uterus fails to expel all the fetal tissue and instead retain some of it, posing a threat of infection and complications. The process is also useful in removing the excessively thick uterine lining caused due to the accumulation of tissues in a condition called polycystic ovary syndrome. Similarly, if abnormal growth of tissues, causing excessive vaginal bleeding is detected, then dilation and curette is recommended. In a few rare cases, the some of the placental matter is retained by the uterus even after childbirth, and dilation and curettage serves to remedy such a situation.
Preparation for the procedure usually begins a couple of hours before the actual surgery takes place. It is necessary that you get the surgery done only under the supervision of a professional medical practitioner in order to avoid complications later. The patient is put under general anesthesia before the surgery begins. Sometimes, the opening of the cervix may need to be widened well in advance of the surgery, in which case you may have to consume or apply such medication as your doctor may prescribe.
The patient is asked to use a sponge device called the osmotic dilator to gradually expand her cervix a couple of hours before the surgery commences. Once the patient is anesthetized, a speculum is introduced into the vagina and an antiseptic solution is used to cleanse the cervix. After this, an instrument with a metal handle and a sharp loop (the curette) is introduced into the vagina and slowly moved into the uterus. Very carefully, this instrument is used to scrape off the lining of the uterus thoroughly. Though the patient can be discharged in a couple of hours after the surgery and can resume normal activities in a day or two, dilation and curettage involves risks. One of the possible complications is injury to the walls of the uterus, which might cause internal bleeding. It could also lead to infection of the fallopian tubes if the patient already has an STD.