Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dilation and curettage (D and C) is a procedure in which the cervix of the uterus is expanded (dilated) so that the uterine lining (endometrium) can be removed with a spoon-shaped instrument called a curet or curette. The procedure is performed for a variety of reasons. Most commonly, this surgery is done in order to help determine the cause of abnormal uterine bleeding. It can also be done to help determine the degree of abnormality of the endometrium
in cancer cases or pre-cancerous cells that are detected by an in-office biopsy. D and C is also sometimes necessary to remove tissue after a miscarriage.
Why is a D and C done?
In general, a D and C is used to help determine the health of the uterine lining or to remove abnormal tissue. Occasionally, the procedure can correct some of the problems in the uterus such as polyps, scar tissue, or tissue overgrowth.
What are reasons not to perform a D and C?
There are very few contraindications to D and C. Generally if a patient is too ill to undergo surgery, she should probably not have this procedure. Furthermore, if the patient is unable to move her legs apart, such as with severe arthritis in the hips, the surgeon may not be able to perform the procedure since it requires enough movement of the legs to accommodate a speculum. If the patient is pregnant or thinks that she could be pregnant, she should not have the operation unless the D and C is for the purpose of an abortion or to treat a miscarriage.
Pre-op: What happens before surgery?
Before a D and C, the same general recommendations for other outpatient procedures apply. It is recommended that the patient take nothing by mouth (food, water, etc.) for at least 6 to 8 hours prior to the scheduled operation. Often, the doctor will see the patient the day before surgery to discuss the procedure and potential complications in greater detail.