Dilatation and curettage or more commonly known as D&C is a two stage process. The first stage, dilatation, involves the widening of the cervix. The second part refers to the process where part of the lining of the uterus and/or the contents of the uterus issurgically removed. The procedure is usually done after a miscarriage or forthe removal of uterine cysts. Dilatation and curettage is done manually or by an electric vacuum device.
History of Dilatation and Curettage
Dilation and curettage procedures were known in the medical world since ancient times and indeed, some very rudimentary apparatus existed in those days. It was not until the mid nineteenth century however, that this procedure was developed, with the evolution of gynecology as a medical specialization.
The word curettage comes from the French word “curette” which means “to cleanse” and was developed in 1723 in France. In the 1870s, Alfred Hegar, a German Physician invented the dilator and this resulted in the popularization of dilation and curettage as an accepted medical procedure.
Purpose of Dilatation and Curettage
Dilation and curettage is carried out for various reasons. Some of them are listed below:
- Abnormal Bleeding: This procedure is done to diagnose the cause of abnormal uterine bleeding.
- Abnormalities in the Endometrium: Dilatation and curettage is also done for studying abnormalities in the endometrium or the lining of the uterus. This is especially useful in cases of cancer, when a biopsy is needed.
- Post-miscarriage Cleansing: In the event of a miscarriage, dilatation and curettage procedures are done to remove the waste tissue.
- Removal of Polyps, Scars and Excess Tissue: D&C is useful for treating benign uterine growths like polyps, scars and excess tissue growth.
- Abortion:This is one of the most commonly known uses of D&C. Abortions are regularly carried out by the method of dilation and curettage.
Types of Dilation and Curettage
There are essentially three types of dilatation which are carried out for abortion. They are:
- Intact Dilatation: This is a process where the fetus is developed enough to be removed but needs the uterus to be dilated in order to remove it properly.
- Dilatation and Evacuation: This procedure is done in the second trimester or second three weeks of pregnancy. The procedure is usually a combination of vacuum aspiration and dilatation and curettage.
- Intrauterine Cranial Decompression: Also known as“partial birth abortion”, it is a dilation procedure where the cervix isdilated and the fetus is removed from the womb, feet-first.
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