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DefinitionWhat is a D&C or Dilation and Curettage? First,
it is a dilation or stretching
open of the
cervix (entrance to the
uterus). A succession of increasingly larger dilation rods are used to
mechanically stretch open the cervix. A medical softening of the
cervix, by the use of misoprostol, can be used for a very atraumatic
dilation. Hereby, some complications such as cervical
lacerations and potentially cervical insufficiency may be avoided or at
least reduced in frequency. Alternately, a specially prepared piece of
material (laminaria) can be placed in the cervix hours before the
procedure to slowly soften and dilate the cervix. This may eliminate
the need for more rapid and forceful mechanical dilation.
Prophylactic antibiotics are usually prescribed at the time of
laminaria placement. Following the cervical dilation, a curette (or long handled metal spoon-like device) is used to scrape, empty, sample or remove contents from within the uterus. For “a suction D&C”, which is used for removing retained tissue from miscarriage or following delivery, hemorrhage, or for an elective pregnancy termination, suction is applied through a hollow plastic tube (a suction curette). A metal spoon-like curette, may also be used in conjunction with this procedure. A blunt or banjo curette is reserved for use during the postpartum time period. Another procedure, often associated with a D&C, is called a D&E (dilation and evacuation). This term is usually reserved for a procedure which is performed after 14 weeks of pregnancy (for miscarriage or elective pregnancy termination). |
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