Can a D and C be Harmful?

D and C surgeries are very safe tests. They can be a way to stop heavy bleeding, diagnose cancer, or to allow a mom with a miscarriage to proceed to planning her next pregnancy. This common simple operation helps us to figure out period problems and other gynecologic disorders. The  Dilatation and Curettage or a "D and C". When we didn't have an ultrasound, and pap tests were not as accurate as they are now, D and C was one of the few diagnostic tools in the toolbox; but still D and Cs can be very valuable tools. Although most modern gynecologists do not perform D and Cs (other than for miscarriages) without also performing a hysteroscopy (actually looking inside), we still perform many D and Cs. So when talking to our patients and recommending performing a D and C, the question comes up what type of harm may come from the procedure. As for any operation, it is possible for the D and C to cause infection, bleeding or actual pain. It is possible to also get scarring of the lining that can cause medical problems. But can a D and C looking for cancer actually be a cause of harm to a patient? Drs Robers, Long and Jonasson did an recent study of cancer patients who had undergone D and Cs. They decided to look for uterine cancer cells in major blood vessels. they found that immediately after vigorous D and C of the endometrium there were cancer cells that found their way into our vena cava, the major venous blood flow path out of the pelvis back to the heart! Gynos don't yet know whether this is actually dangerous, or whether this represents a common occurrence more than menstrual cells which can hit the circulation regularly, but it's an interesting finding and one you may want to speak to your gyno about.


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