Dilation and

Curettage
Presented by:
Kadiza Arabi BSN-2B
Nhadzmahal Asmadul- 2D
 What is Dilation and
Curattage (D&C)?
Dilation and curettage (D&C) is a procedure to remove tissue from inside your
uterus. Health care providers perform dilation and curettage to diagnose and
treat certain uterine conditions — such as heavy bleeding — or to clear the
uterine lining after a miscarriage or abortion.

In a dilation and curettage, your provider uses small instruments or a

medication to open (dilate) the lower, narrow part of your uterus (cervix). Your
provider then uses a surgical instrument called a curette, which can be a sharp
instrument or suction device, to remove uterine tissue.
Terminologies
Dilation- opening of the uterus Molar pregnancy - occurs when an
Curettage- aspiration or remove of egg and sperm join incorrectly at
tissue inside the uterus. fertilization and a noncancerous
tumor forms instead of a healthy
Uterus- is a hollow muscular organ
placenta.
located in the female pelvis between
Uterine polyps- are growths
the bladder and rectum. attached to the inner wall of the
Cervix- The lower, narrow end of the uterus that extend into the uterine
uterus that forms a canal between the cavity.
uterus and vagina.
 The Purpose and
Indication
A D&C may be used as a diagnostic or therapeutic procedure for
abnormal bleeding. A D&C may be performed to determine the
cause of abnormal or excessive uterine bleeding, to detect cancer,
or as part of infertility (inability to become pregnant) investigation.

A suction D&C uses suction to remove uterine contents. A suction D&C

may be used following a miscarriage to remove the fetus and other
tissues if they have not all been naturally passed. Infection or heavy
bleeding can occur if these tissues are not completely removed.

The indication for this procedure
are:
To prevent infection or heavy
bleeding by clearing tissues that
remain in the uterus after a
miscarriage or abortion
Remove a tumor that forms instead
Indications for the D&C in the pregnant
patient include:
elective termination of pregnancy,
early pregnancy failure,
evacuation of a molar pregnancy, or
suspected retention of products of
conception.

of a typical pregnancy (molar

The pregnant D&C is usually performed

pregnancy). with either manual or electric vacuum
Treat excessive bleeding after aspiration.
delivery by clearing out any placenta
that remains in the uterus.
Remove cervical or uterine polyps,
which are usually noncancerous
(benign)
 Contraindication
If the patient is too ill to undergo procedures.
If the patient is unable to move her legs
apart, such as with severe

arthritis in the hips.

If the patient has problem with clotting
mechanism of the body.
.
 Preparation
Dilation and curettage can be done in a hospital, clinic
or your provider's office, usually as an outpatient
procedure.
Before the procedure:

Avoid eating or drinking the day of the surgery.

Get a physical exam to make sure you're healthy
enough for the procedure.
Visit your doctor the day before so they can apply a
gel to start the process of opening your cervix.
Follow your provider's instructions on limiting food
and drink.
Arrange for someone to take you home because you
may be drowsy after the anesthesia wears off.
Allow time for the procedure and a few hours of
recovery afterward.
Materials
Uterine curette
Sponge holder
Sim's speculum
Vulsellum forcep
Uterine sound
Hegar's dilator
Ovum holding forceps
Kidney tray
Psychological Preparation
Enhance the knowledge of the patients regarding
the procedure.
Explain the prons and cons of this procedure
Possible complication that might happen
Prevention of complication

The Nurses role’s in psychological care are being able to

provide the resources and education particular to the
individual’s client needs.

-Therapeutic communication with the client

-Maintaining dignity and self-esteem of a client.
-Providing a comfortable and peaceful environment.
-Provide holistic care to a client
-Prevent abandonment and isolation to a client.
 Drugs
Misoprostol (cytotec) (to
promote dilation)
Antibiotic – (to prevent infection)
Anesthetics – to keep from
feeling in pain during the
procedure.
 Description of the
procedure
A procedure to scrape and remove tissue from
the inner lining of the uterus. The cervix is
dilated (made larger) and a curette (spoon-
shaped instrument) is inserted into the uterus to
remove tissue. A tissue sample may then be
checked under a microscope for signs of disease,
such as infection or cancer.

In general, it’s done to Remove tissue in the

uterus during or after a miscarriage or abortion
or to remove small pieces of placenta after
childbirth. This helps prevent infection or heavy
bleeding. And It usually takes only 10 to 15
minutes, but you may stay in the office, clinic, or
hospital for up to five hours.
Nursing Responsibilities
Provide teaching care to the client or someone who will taking care of the
client.
Inform not to use tampons and having sex for a while after the procedure
wait for the providers tells when to resume Having sex and using tampons.
Encourage to used sanitary pads or any pads for bleeding.
Instruct patients it take 2-3 days for a complete recovery and she can
resume his daily routine 1-2days after the procedure.
Instruct patient to inform the nurse and the provider’s to report if she
experiencing any symptoms (abdominal pain, fever, heavy bleeding, severe
cramps, unusual or bad-smelling discharge After the procedure.
Inform patient that her next menstrual period onset will be delayed.
Instruct Patient to Avoid heavy exercise like heavy lifting and strenuous
exercise. after the procedure
 Questions:
1. What is the procedure to remove tissue from inside your uterus?

2. What is the Purpose of D&C procedure?

3. What are the materials needed in this procedure?

4.What happens if you don't have a D&C after a miscarriage