Dilation And Curettage

WHAT YOU SHOULD KNOW: y

Dilation and curettage (D and C) is a procedure to remove tissue from the lining of your uterus (womb). You may need a D and C if you have symptoms, such as abnormal vaginal bleeding. Abnormal vaginal bleeding occurs when it is not time for your monthly period, or after menopause. If you have heavy vaginal bleeding after giving birth, you may need a D and C. If placental tissue is retained (remains) in your uterus after giving birth, you may need a D and C to remove it. The placenta supplies food and oxygen to your unborn baby inside your uterus during pregnancy. You may also retain tissue in your uterus after a miscarriage (death of an unborn baby). Retained tissue can lead to heavy bleeding and infection. A D and C may be done to abort (end) a pregnancy. A D and C may also be done to remove a growth, or to help diagnose uterine cancer. During a D and C, your cervix (opening of the uterus) is dilated (widened). Your caregiver may remove tissue from your uterus with a curette (sharp tool), vacuum suction, or forceps (grasping tool). If you have a miscarriage after 13 weeks of pregnancy, larger amounts of tissue may need to be removed. Having a D and C may help you and your caregivers learn the cause of your symptoms. A D and C may stop your abnormal or heavy vaginal bleeding. A D and C may prevent you from getting a life-threatening infection from retained tissue in your uterus.

CARE AGREEMENT:
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS: y
If you are awake during your D and C, you may have pain while the tissue is removed. Your uterus, cervix, intestines (bowel), or nearby tissue may be torn or damaged. You may have life-threatening blood loss, and need a blood transfusion or another surgery. You may need to have your uterus removed. You may get an infection in your uterus that could spread to your blood and become lifethreatening. You may have a reaction to the anesthesia medicines, and you may die. After your D and C, you may have nausea (upset stomach), vomiting (throwing up), dizziness, or a headache. Scar tissue may form in your uterus. You may need another D and C to remove more tissue from your uterus. If cancer caused your abnormal vaginal bleeding, lab tests may not detect the cancer in your uterus. If your D and C was done to end a pregnancy, you have an increased risk for a future miscarriage. You are also at risk for pre-term (early) delivery during a future pregnancy. If you do not have a D and C, your symptoms, such as vaginal bleeding, may continue. Caregivers may not find the cause of your symptoms, and you may not get proper treatment. Retained uterine tissue may cause a life-threatening infection. If you lose too much blood from heavy vaginal bleeding, you may die. Talk with your caregiver if you have questions or concerns about your condition or treatment.

WHILE YOU ARE HERE:

Before your procedure: y
Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered. IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

o o o

Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria. Cervical dilator medicines: Cervical dilator medicine may be put into your cervix to help it dilate before your procedure. Immune globulin: You may be given immune globulin medicine if your blood is Rh-negative, and you had a miscarriage. Immune globulin helps prevent problems with a future pregnancy. Ask your caregiver for more information about Rh-negative blood and immune globulin. Non-steroidal anti-inflammatory medicine: This family of medicine is also called NSAIDs. NSAIDs may be given to help decrease pain and inflammation (swelling). Sedative: This medicine is given to help you stay calm and relaxed.

Tests:

Blood tests: You may need blood taken for tests, and to check your blood type. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. You may also have blood tests after your procedure to check your health. Ultrasound: You may need an ultrasound of your uterus before your D and C. During an ultrasound, sound waves show pictures of your uterus on a TV-like screen. This test may help your caregiver see the tissue in your uterus that needs to be removed. Vaginal swab: Your caregiver may swab your vagina to check for a vaginal infection.

Anesthesia: Anesthesia medicine is given to make you comfortable during your procedure. Caregivers work with you to decide which anesthesia is best, and whether you will be awake or asleep. Do not make important decisions for 24 hours after having anesthesia. Also, do not drive or use heavy equipment. An adult may need to drive you home and stay with you after you have had anesthesia. You may be given any of the following:

During your procedure: y

Your caregiver checks your cervix to see if it is dilated. If needed, your caregiver may use tools to dilate your cervix. Ultrasound may be used to guide your caregiver during your D and C. Your caregiver may use a curette to remove tissue from your cervix and uterus. Your caregiver may use suction, instead of a curette, to remove tissue from your uterus. To use suction, your caregiver inserts a thin tube into your uterus. The tube is connected to a suction machine or a syringe, and the tissue is removed through the tube. Forceps may also be used to remove larger amounts of tissue from your uterus. Tissue removed during your D and C may be sent to a lab for tests. Medicines may be given to help your uterus tighten and prevent heavy bleeding after your D and C.

After your procedure:

You are taken to a room to rest. Do not get out of bed until your caregiver says it is okay. When your caregiver sees that you are not having any problems, you may be able to go home. If you are staying in the hospital, you will be taken to your room.

Ateneo De Davao University

In Partial Fulfillment Of The Requirements In Related Learning Experiences

Submitted By:
Braezelle Mae Yu BSN 4E - group3

Submitted to:
Maam Annabel Bauzon, RN,MN