DNC stands for Dilation and Curettage and is a gynaecological procedure done for several different purposes. It can be both diagnostic and therapeutic while most often it is performed as an outpatient procedure. Although the patient could go home on the same day following a DNC, it is up to the doctors to decide who can go home and who should be observed further.
Why should DNC be performed?
The procedure will allow the doctors to scrape the inner wall of the uterus or else suck the tissues that are left over in the uterus depending on the nature of the clinical diagnosis. Perhaps the commonest condition which necessitates a DNC is a miscarriage while the next possible reason could be to diagnose the cause and to cure a heavy or abnormal vaginal bleeding among certain women. In most instances, the procedure is both diagnostic as well as therapeutic.
What are the pre-procedure preparations required for a DNC?
As with any other surgical procedure, avoiding foods and drinks on the day of the procedure should be enough in most instances. However, one should consult the doctors who are performing the DNC for advice regarding the pre-procedure preparations. It is most likely that one would be given these instructions by the health care team well before the procedure date. On the day of the procedure, one should make arrangements for someone to come and pick her up as the person undergoing the DNC may not be able to drive due to discomforts as well as due to residual effects of the anesthesia.
What will happen during the procedure?
In the operation theatre, the doctors will start the procedure by giving anesthesia either through a vein or else as a regional or local injection. The type of anesthesia will be determined by the doctors concerned and will explain to the patient before the injections are given. If general or regional anesthesia is given, a cannulae will be placed on the arm or in the neck while a sedating agent could be given via a mask, just prior to the procedure. At the same time, a dose of antibiotics will also be given as a prophylactic measure for infections.
Following giving the anesthesia, the patient would be laying on the back while the feet will rest on a stirrup. A speculum will be inserted through the vagina to visualize the cervix which is the opening into the uterus. If the cervix is closed, gradual dilation with a device known as a dilator will be performed in order to gain the necessary access space. Usually, the amount of cervical width required for a DNC procedure is around 5 – 7 mm.
After dilation, an instrument called the curette will be inserted into the uterus and the uterine wall will be scraped gently in order to remove the left over material following conception or else the abnormal tissue layers on the uterine wall. The procedure usually takes around 15 to 20 minutes and should not cause any discomfort to the anesthetized patient.
The material that has been taken out during the DNC procedure will be sent to the lab for further investigations.
What happens after the procedure?
Following a DNC, the patient will be observed for few hours and the major concerns during this period would be the persistent bleeding. At the same time, the health care team will also be looking for anesthesia related complications although nausea, vomiting, slight cramping feeling and mild spotting are considered normal post-op manifestations.
After few hours, the patient may go home with a prescription for antibiotics, pain relievers, and advice on follow-up visits.
What are the possible complications following a DNC?
Among the rare but significant complications, hemorrhage, uterine rupture, infections as well as cervical tears could be highlighted.
What signs should alert immediate medical care following a DNC?
If the bleeding and the cramping feeling continue for more than 2 weeks, one should seek the advice of the doctor. At the same time, the appearance of a fever spike or a foul smelling discharge should also warrant immediate medical treatment with strong antibiotics and further investigations.