Difference between revisions of "Dilation and curettage"

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Dilation and curettage (D&C), a commonly performed procedure in obstetrics and gynecology, refers to dilation of the cervix in order to introduce instruments into the uterus, with a curette being used to empty or sample the endometrial cavity.
 
The indication for a D&C may be diagnostic or therapeutic.  Diagnostic D&C has largely been replaced by an office endometrial biopsy.  However, certain scenarios, including (but not limited to) the inability to tolerate office biopsy due to pain or anxiety, insufficient sampling, the need to exclude endometrial cancer, and cervical stenosis, may necessitate an operative diagnostic D&C over office endometrial biopsy<ref name=":0">{{Citation|last=Cooper|first=Danielle B.|title=Dilation and Curettage|date=2021|url=http://www.ncbi.nlm.nih.gov/books/NBK568791/|work=StatPearls|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=33760550|access-date=2021-05-08|last2=Menefee|first2=Gary W.}}</ref>.
 
Indications for therapeutic D&C in the pregnant patient are: elective termination of pregnancy, treatment of early pregnancy failure (missed or incomplete spontaneous abortion), evacuation of suspected molar pregnancy, and suspected retained products of conception<ref name=":0" />.
 
Therapeutic D&C may be indicated as a temporizing measure in the non-pregnant patient with abnormal uterine bleeding<ref>{{Cite journal|date=2013-04-XX|title=Committee Opinion No. 557: Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women|url=https://journals.lww.com/00006250-201304000-00042|journal=Obstetrics & Gynecology|language=en|volume=121|issue=4|pages=891–896|doi=10.1097/01.AOG.0000428646.67925.9a|issn=0029-7844}}</ref>.{{Infobox surgical case reference
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Provide a brief summary of this surgical procedure and its indications here.


== Preoperative management ==
== Preoperative management ==

Revision as of 17:35, 7 May 2021

Dilation and curettage (D&C), a commonly performed procedure in obstetrics and gynecology, refers to dilation of the cervix in order to introduce instruments into the uterus, with a curette being used to empty or sample the endometrial cavity.

The indication for a D&C may be diagnostic or therapeutic. Diagnostic D&C has largely been replaced by an office endometrial biopsy. However, certain scenarios, including (but not limited to) the inability to tolerate office biopsy due to pain or anxiety, insufficient sampling, the need to exclude endometrial cancer, and cervical stenosis, may necessitate an operative diagnostic D&C over office endometrial biopsy[1].

Indications for therapeutic D&C in the pregnant patient are: elective termination of pregnancy, treatment of early pregnancy failure (missed or incomplete spontaneous abortion), evacuation of suspected molar pregnancy, and suspected retained products of conception[1].

Therapeutic D&C may be indicated as a temporizing measure in the non-pregnant patient with abnormal uterine bleeding[2].

Dilation and curettage
Anesthesia type
Airway
Lines and access
Monitors
Primary anesthetic considerations
Preoperative
Intraoperative
Postoperative
Article quality
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Preoperative management

Patient evaluation

System Considerations
Neurologic
Cardiovascular
Respiratory
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Labs and studies

Operating room setup

Patient preparation and premedication

Regional and neuraxial techniques

Intraoperative management

Monitoring and access

Induction and airway management

Positioning

Maintenance and surgical considerations

Emergence

Postoperative management

Disposition

Pain management

Potential complications

Procedure variants

Variant 1 Variant 2
Unique considerations
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications

References

  1. 1.0 1.1 Cooper, Danielle B.; Menefee, Gary W. (2021), "Dilation and Curettage", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 33760550, retrieved 2021-05-08
  2. "Committee Opinion No. 557: Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women". Obstetrics & Gynecology. 121 (4): 891–896. 2013-04-XX. doi:10.1097/01.AOG.0000428646.67925.9a. ISSN 0029-7844. Check date values in: |date= (help)