Nursing Care Plan – Dilatation and Curettage (D & C)

Dilatation and curettage, also called as D&C, is a common surgical procedure done on women to scrape and collect the tissue from inside the uterus. The cervical passage in a women leads to the uterus. ‘Dilatation’ is a widening of the cervical passage. This is done using smoothly conical and tapered, graduated metal rods of various sizes and these are appropriately called the dilators. The gradually large metal dilators lead to widening of the tight cervical passage slowly. Curettage (“C”) is the second part of the procedure and is done to scrape the inside contents of the uterus. For this, a sharp spoon-like instrument called curette is used. The procedure is usually performed under general or regional anaesthesia.

Clinical Uses:

  1. D&C is used to help determine the health of the uterine lining or to remove abnormal tissue.
  2. Occasionally, the procedure can correct some of the problems in the uterus such as polyps, scar tissue, or tissue overgrowth.

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).

Possible Complications:

  • It is normal to experience vaginal bleeding and/or pelvic cramping (similar to menstrual cramping) for a few days after a D&C. Over-the-counter pain medications are usually sufficient for pain control.
  • Perforation of the uterus with either the dilators or the curette
  • Injury to the cervix is another possible complication.
  • Infection

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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