DILATION AND CURETTAGE

Course overview

DILATION AND CURETTAGE (D&C) IS ONE OF THE MOST COMMON INVASIVE PROCEDURES IN THE UNITED STATES. THE PROCEDURE CAN BE PERFORMED ON A PREGNANT OR NONPREGNANT PATIENT AND BE EITHER DIAGNOSTIC OR THERAPEUTIC. SOMETIMES THE CIRCUMSTANCES LEAD TO A DIAGNOSTIC PROCEDURE BECOMING THERAPEUTIC. A D&C OCCURS IN 2 STEPS: DILATION OF THE CERVIX AND CURETTAGE OF THE ENDOMETRIAL CAVITY. WHILE CURRENT RECOMMENDATIONS FOR ENDOMETRIAL SAMPLING IN THE NONPREGNANT PATIENT INCLUDE HYSTEROSCOPY WITH DIRECTED ENDOMETRIAL SAMPLING, IF NECESSARY RESOURCES ARE UNAVAILABLE, A SIMPLE D&C MAY BE PERFORMED TO ACQUIRE TISSUE FOR HISTOLOGIC EVALUATION. CONTRAINDICATIONS TO D&C ARE FEW, AND THE OVERALL MORTALITY RATE IS LOW. THIS ACTIVITY REVIEWS THE INDICATIONS, ABSOLUTE AND RELATIVE CONTRAINDICATIONS, EQUIPMENT NEEDS, TECHNIQUE, AND COMPLICATIONS OF DIAGNOSTIC AND THERAPEUTIC D&C IN PREGNANT AND NONPREGNANT PATIENTS. IN ADDITION, THE ROLE OF THE HEALTHCARE TEAM IN IMPROVING CARE FOR PATIENTS UNDERGOING D&C IS HIGHLIGHTED.