Dilation and Curettage at Apollo Hospitals, Lucknow

Dilation and Curettage (D&C) is a short gynaecological procedure in which the cervix is gently opened and the inner lining of the uterus is sampled or removed. At Apollomedics Super Speciality Hospital, Lucknow, D&C is offered as part of a wider obstetrics and gynaecology service, with pre-anaesthetic assessment, day-care operation theatre facilities and histopathology support under one roof.

Why patients choose Apollo Hospitals, Lucknow for D&C

• Multi-consultant gynaecology team: the Lucknow unit lists a group of obstetrics and gynaecology specialists, several with more than 15-20 years of individual practice, giving the department a combined clinical experience running into several decades. Exact doctor allocation for your case is confirmed at the time of booking.
• Apollo group legacy: part of the Apollo Hospitals network, which began in 1983 and now operates a large multi-city hospital group in India, so protocols, audit systems and infection-control practices follow group-wide standards.
• Diagnostic depth before surgery: in-house ultrasound including transvaginal scanning, colour Doppler, laboratory services and on-site histopathology, so an endometrial sample can be processed without sending tissue out of the city.
• Modern operating facilities: dedicated modular theatres, anaesthesia monitoring, and availability of hysteroscopy so that D&C can be done under vision rather than blind curettage where clinically indicated.
• Day-care pathway: most uncomplicated D&C cases are planned as same-day admission and discharge, which matters for women travelling in from outside Lucknow.
• Care across age groups: adolescents with heavy menstrual bleeding, women in the reproductive years with miscarriage or fertility concerns, and postmenopausal women needing endometrial assessment are each managed with age-appropriate consent, counselling and anaesthetic planning.
• Emergency and obstetric back-up: 24x7 emergency services, blood bank support and critical care are available on campus should a case turn out to be complicated, such as heavy bleeding or retained products of conception.
• Counselling and follow-up: pregnancy loss is not only a surgical event. The team supports counselling, contraception advice, and planning for a future pregnancy at follow-up.

Overview

Dilation and Curettage (D&C) is a surgical procedure that plays a significant role in women's health. At Apollo Hospitals Lucknow, we work to maintain high standards of clinical care and to keep the trust our patients place in us. Our team of experienced gynaecologists uses current technology and techniques to support safety and effectiveness during the D&C procedure. Whether you are facing abnormal uterine bleeding, miscarriage or other gynaecological concerns, the team aims to provide care tailored to your individual situation rather than a single fixed protocol.

Why Dilation and Curettage is Necessary

Dilation and Curettage may be necessary for several medical reasons. The procedure involves dilation of the cervix and removal or scraping of the uterine lining, allowing tissue to be taken for diagnostic or therapeutic purposes. Common indications include:

• Abnormal uterine bleeding: persistent or heavy bleeding can indicate underlying conditions such as fibroids or polyps. A D&C, often combined with hysteroscopy, can help diagnose and in some cases treat these problems.
• Miscarriage management: after a miscarriage, a D&C may be required to remove remaining tissue from the uterus, reducing the risk of complications such as infection or continued bleeding.
• Endometrial biopsy: a D&C can be performed to obtain tissue samples for examination, helping to assess conditions such as endometrial hyperplasia or endometrial cancer.
• Retained placental tissue: after childbirth, a D&C may be needed to remove retained placental tissue that could otherwise cause bleeding or infection.

The benefits of undergoing a D&C at Apollo Hospitals Lucknow include access to well-equipped facilities, a team of specialists, and a commitment to patient-centred care.

Risks of Delay

Delaying a Dilation and Curettage procedure can lead to complications. Untreated abnormal uterine bleeding can result in iron deficiency anaemia, which is already common among Indian women. Retained tissue after a miscarriage can lead to infection or prolonged bleeding. Conditions such as endometrial hyperplasia, particularly with atypia, carry a risk of progression to cancer if not assessed and treated. At Apollo Hospitals Lucknow, timely assessment is encouraged so that treatment decisions are made on evidence rather than guesswork, and unnecessary waiting is avoided.

Benefits of Dilation and Curettage

• Accurate diagnosis: tissue examination allows a histological diagnosis, which guides further treatment.
• Symptom relief: many patients report relief from heavy bleeding or cramping pain after the procedure, although this is not guaranteed and depends on the underlying cause.
• Preventive value: identifying pre-cancerous or treatable changes early can help avoid more serious problems later.
• Emotional closure: for women who have experienced a miscarriage, completing the process can help with emotional healing and allow planning for the future.

At Apollo Hospitals Lucknow, we want patients to understand both the benefits and the limits of D&C, and to feel supported throughout.

Preparation and Recovery

Preparation tips

• Consultation: attend a detailed consultation with your gynaecologist to discuss your medical history, medications and concerns.
• Pre-operative instructions: follow instructions on fasting, dietary restrictions and adjustment of medicines such as blood thinners.
• Arrange transport: as D&C is usually performed under sedation or anaesthesia, arrange for someone to accompany you home.

Recovery tips

• Rest: allow time to recover and avoid strenuous activity for a few days.
• Follow-up care: attend scheduled appointments so that biopsy results and recovery can be reviewed.
• Watch for symptoms: report excessive bleeding, fever, foul-smelling discharge or severe pain promptly.

The team at Apollo Hospitals Lucknow provides support before, during and after the procedure to help recovery go smoothly.

Current guidance and what has changed

Practice in India broadly follows guidance from the Federation of Obstetric and Gynaecological Societies of India (FOGSI) along with international guidance from the Royal College of Obstetricians and Gynaecologists (RCOG), the American College of Obstetricians and Gynecologists (ACOG) and the World Health Organization. Several important shifts have taken place, and your surgeon will discuss how they apply to you:

• Blind D&C is no longer first choice for abnormal uterine bleeding. Current guidance, including FOGSI's good clinical practice recommendations on abnormal uterine bleeding and the FIGO PALM-COEIN classification system, favours transvaginal ultrasound and hysteroscopy with directed or office endometrial biopsy, because curettage alone can miss focal lesions such as polyps and localised hyperplasia.
• Miscarriage management is now offered as a choice of three routes. RCOG and WHO guidance supports expectant (wait and watch), medical (misoprostol, with or without mifepristone) and surgical management, with vacuum aspiration preferred over sharp curettage where surgery is chosen. WHO's abortion care guideline (2022) recommends against sharp curettage as a routine method and advises replacing it with vacuum aspiration or medical methods.
• Manual vacuum aspiration (MVA) and electric vacuum aspiration are the preferred surgical techniques for first-trimester uterine evacuation in Indian public health and FOGSI training programmes, and are frequently done under local or paracervical block.
• Postmenopausal bleeding requires endometrial assessment. Guidance supports transvaginal ultrasound endometrial thickness measurement followed by biopsy, with hysteroscopy where sampling is inadequate or bleeding persists.
• Retained products of conception are increasingly managed by hysteroscopic resection in selected cases, to reduce the risk of intrauterine adhesions (Asherman syndrome) that can follow repeated sharp curettage.
• Antibiotic prophylaxis is recommended for surgical uterine evacuation in pregnancy-related indications, but is not routine for a simple diagnostic curettage in a non-pregnant woman.
• Anti-D immunoglobulin is considered for Rh-negative women undergoing surgical management of miscarriage or termination, so your blood group will be checked.

The practical message is that D&C remains a valid and sometimes essential procedure, but it is now used more selectively and often alongside or replaced by hysteroscopy, vacuum aspiration or medical treatment.

Questions most other pages do not answer

Many pages on this topic in India describe only what a D&C is and list generic risks. Points that are frequently left out, and which are covered below, include: how the procedure differs from vacuum aspiration and hysteroscopy, whether D&C affects future fertility, how the day of admission actually runs, what happens if you decline the procedure, how Indian household habits such as squatting toilets and floor sleeping affect recovery, insurance waiting periods and how maternity or pregnancy-related claims are treated, and how women travelling from districts around Lucknow should plan their trip.

Timing of the procedure and the preparation phase

• For abnormal bleeding or endometrial assessment: the procedure is usually planned soon after a bleeding episode settles, or at a point in the cycle chosen by your doctor so that the tissue is easiest to interpret. It is generally not done when active heavy bleeding makes anaesthesia unsafe, unless it is being done to control that bleeding.
• For miscarriage: timing depends on the ultrasound findings, the amount of bleeding, whether there is infection, and your own preference between waiting, medicines or surgery. Where there is heavy bleeding, sepsis or haemodynamic instability, evacuation is treated as urgent.
• For retained placental tissue after delivery: timing is guided by bleeding, fever and ultrasound findings, and may be immediate or after a short course of antibiotics.
• Preparation phase, typically 1 to 7 days: consultation and examination, pelvic ultrasound, blood tests including haemoglobin, blood group and Rh typing, infection screening as advised, pregnancy test where relevant, pre-anaesthetic check-up, and review of medicines such as aspirin, clopidogrel, warfarin or newer anticoagulants and of diabetes medicines including insulin.
• Fasting: usually six to eight hours for solids as instructed by the anaesthesia team. Do not fast on your own without instructions, particularly if you have diabetes.

Alternatives and technique options compared

Procedures sometimes performed at the same sitting

• Diagnostic or operative hysteroscopy, including polypectomy or resection of a submucous fibroid
• Cervical polypectomy or cervical biopsy
• Insertion of a levonorgestrel intrauterine system or copper IUCD, when contraception or lining control is planned
• Endometrial ablation in selected women who have completed their family and have no suspicious pathology
• Cervical dilatation for cervical stenosis
• Laparoscopy, where an additional pelvic problem such as endometriosis or adhesions is being assessed
• Anti-D injection for Rh-negative women, and iron therapy or transfusion where anaemia is significant

Phase-by-phase recovery

When you can return to normal activity

• Desk or office work: often within 2 to 4 days if bleeding and pain are settled.
• Household work and cooking: light tasks within a few days; avoid lifting heavy vessels, water buckets or gas cylinders for about a week.
• Squatting and Indian-style toilets: squatting is usually possible once cramping settles, but may feel uncomfortable in the first few days. Use a Western toilet or a low stool if available, and hold a support while rising.
• Sitting cross-legged and floor sleeping: both are generally safe. Get up in stages rather than in one movement while cramping continues, especially after sedation on the first day.
• Bathing: showers are fine. Avoid tub baths, swimming pools, ponds and river bathing until bleeding stops, to reduce infection risk.
• Intercourse and tampons: usually avoided until bleeding has stopped and as per your doctor's advice, commonly one to two weeks.
• Gym, yoga and running: gentle walking from day one; structured exercise, weights and inversions usually after about two weeks, guided by comfort and bleeding.
• Travel: short local travel is generally fine after 24 hours; long journeys are better postponed for a few days, and after a general anaesthetic air travel is usually avoided for at least 24 to 48 hours.
• Two-wheeler riding: avoid as pillion or rider for a few days, since bumpy roads worsen cramping.

Reducing the chance of needing a repeat procedure

• Complete the follow-up visit and read the histopathology report with your doctor; some conditions such as hyperplasia need repeat sampling at planned intervals.
• Where hormonal treatment or an LNG-IUS is advised for heavy bleeding, using it consistently reduces the likelihood of repeat curettage.
• Treat anaemia properly with iron and dietary correction; unrecognised anaemia makes bleeding episodes far more disabling.
• Weight management, control of diabetes, thyroid disorders and management of polycystic ovary syndrome all matter, since these influence endometrial health.
• Use contraception as planned if pregnancy is not desired soon after a miscarriage, and seek early antenatal booking in a subsequent pregnancy.
• Where recurrent miscarriage has occurred, ask about investigation rather than accepting repeated evacuations without assessment.
• Report any postmenopausal bleeding, however slight, without delay.

Adolescents, older women and other special situations

• Adolescents: heavy bleeding in teenagers is usually hormonal or due to a bleeding disorder, and blind curettage is rarely appropriate. Assessment focuses on blood counts, coagulation testing, thyroid function and hormonal treatment. Consent involves the parent or guardian along with the young person.
• Postmenopausal women: the priority is ruling out endometrial cancer. The cervix can be narrow and stiff, so cervical preparation or hysteroscopic guidance may be needed, and the anaesthetic plan takes account of hypertension, diabetes, heart disease and joint problems.
• Women wishing to conceive: repeated or aggressive curettage can cause intrauterine adhesions, so techniques that minimise trauma, such as vacuum aspiration or hysteroscopic removal, are preferred where feasible. Discuss your fertility plans before surgery.
• Women on blood thinners or with bleeding disorders: a coordinated plan with the physician or haematologist is needed on when to stop and restart medication.
• Fibroid uterus or previous caesarean: the uterine cavity may be distorted and scarred, which raises the technical difficulty and is discussed as part of consent.
• Rh-negative women: anti-D immunoglobulin is considered for pregnancy-related evacuation.

What happens if you choose not to have the procedure

Declining is a legitimate choice, and for some indications there are reasonable alternatives. The consequences depend on why the procedure was advised:

• Incomplete miscarriage: many resolve with medicines or with time, but ongoing bleeding, infection or the need for emergency surgery remain possible. You would need clear instructions on danger signs and access to care.
• Suspected endometrial pathology or postmenopausal bleeding: without a tissue sample, hyperplasia or cancer cannot be excluded. Delay here can allow disease to progress, and this is the situation in which declining carries the greatest risk.
• Heavy menstrual bleeding without suspicious features: hormonal treatment, tranexamic acid and an LNG-IUS are genuine alternatives, with a plan for review if bleeding continues.
• Retained placental tissue: antibiotics alone may not clear the tissue, and prolonged bleeding or infection can follow.

If you prefer to wait, ask for the specific danger signs, the review interval and the name of the person to contact, and record that plan in writing.

What influences the cost

Charges vary from patient to patient. Apollo Hospitals Lucknow does not publish a fixed price for D&C on its procedure page, so please ask the reception, billing desk or insurance desk for an estimate for your specific plan. The factors below explain why estimates differ.

Insurance and cashless treatment in India

• Day-care recognition: most Indian health insurance policies now cover listed day-care procedures that do not need a 24-hour admission, and uterine curettage is commonly among them. Confirm the wording of your own policy.
• Pre-authorisation: for a planned procedure, cashless approval is normally sought a few days in advance. Give the insurance desk your policy number, e-card, ID proof and the doctor's advice note.
• Waiting periods: policies usually have an initial waiting period of about 30 days for illness, and a longer specific waiting period, often two to four years, for named gynaecological conditions such as fibroids, endometriosis, dysfunctional uterine bleeding and polyps. Pre-existing disease waiting periods also apply. These often decide whether a claim for abnormal bleeding is payable.
• Planned versus accident or emergency cover: emergency evacuation for heavy bleeding after a miscarriage is treated as an emergency admission and pre-authorisation is applied for after admission, whereas a planned diagnostic D&C follows the planned route. Accident cover does not usually apply to gynaecological illness.
• Maternity and pregnancy clauses: pregnancy-related treatment is often excluded unless a maternity benefit is included, and maternity benefits commonly carry a waiting period of two to four years. Claims for miscarriage-related evacuation depend heavily on this clause, so check before admission.
• TPA process: if your policy is administered by a third-party administrator, approval passes through the TPA and may take a few hours to a couple of days. Non-medical items, some consumables and a proportionate room-rent deduction may not be payable.
• Government and employer schemes: if you are covered by a state scheme, CGHS, ECHS or an employer panel, ask the desk whether the hospital is empanelled for your specific scheme, since empanelment varies by scheme and package.
• Keep documents: retain discharge summary, operation notes, histopathology report, investigation reports and original bills, whether you are claiming cashless or by reimbursement.

Planning the admission and what to bring

• Photo ID such as Aadhaar, insurance card or e-card, policy details and TPA card
• All previous prescriptions, ultrasound films and reports, previous biopsy or hysteroscopy records
• Current medicines in their original strips, including diabetes, thyroid, blood pressure and blood thinning medicines
• Loose cotton clothing, a front-open kurta, slippers, sanitary pads and disposable underwear
• A responsible adult attendant who can sign consent-related paperwork if needed and take you home
• Remove jewellery, nose pins, toe rings, bangles, nail polish and contact lenses before theatre; leave valuables at home
• Confirm fasting time, reporting time and whether the case is planned as day care or overnight
• Plan childcare in advance; in joint families, agree who will handle cooking and school runs for two to three days so you can actually rest
• Arrange a private space at home if you have had a pregnancy loss and need quiet time; well-meaning visitors can be tiring

Warning signs that need review

• Soaking more than one pad an hour for two hours or more, or passing large clots
• Fever above 38 ?C, chills or foul-smelling vaginal discharge
• Severe or worsening abdominal pain not relieved by prescribed painkillers
• Fainting, dizziness on standing, breathlessness or a racing heartbeat
• Vomiting that prevents you from keeping fluids or medicines down
• No return of periods after two months, or unusually scanty periods with cyclical pain, which may suggest intrauterine adhesions
• A positive pregnancy test weeks after evacuation, or persistent bleeding, which needs assessment for retained tissue

Do not wait for the next scheduled appointment if any of these occur. Use the hospital emergency service, which operates 24x7.

For patients travelling from nearby districts and cities

Lucknow serves a wide catchment, and many women come in from Barabanki, Sitapur, Hardoi, Unnao, Rae Bareli, Kanpur, Sultanpur, Ayodhya, Bahraich, Gonda, Lakhimpur Kheri, Amethi, Pratapgarh, Shahjahanpur, Basti and Gorakhpur, as well as from parts of Bihar and Nepal border districts.

• Carry all previous reports and scan films; repeating investigations wastes a trip.
• Where possible, ask whether consultation, tests and pre-anaesthetic check-up can be scheduled on the same day.
• Plan to stay in Lucknow for the night after the procedure if your journey is more than two to three hours, or if you have had general anaesthesia.
• Bring one attendant who can stay with you, and keep a second contact number reachable.
• The histopathology report usually takes several working days. Ask whether it can be shared electronically and whether follow-up can be done by teleconsultation, so that you only travel again if a procedure or examination is needed.
• Avoid long bus journeys on rough roads immediately after the procedure; train or car travel is usually more comfortable.
• Keep enough medicine for the journey home and know the nearest hospital to your village or town in case of heavy bleeding en route.

Contact and appointments

Frequently asked questions

What are the risks associated with Dilation and Curettage?

D&C is generally safe, but like any surgical procedure it carries risks. These include infection, heavy bleeding, injury to the cervix or uterus including perforation, anaesthetic reactions, incomplete removal of tissue and, uncommonly, intrauterine adhesions. The team takes precautions to reduce these risks, and any complication is explained and managed openly.

How long does the D&C procedure take?

The procedure itself usually takes about 15 to 30 minutes. Allow additional time for admission, pre-operative preparation and recovery from anaesthesia, so the hospital visit commonly lasts several hours. Your team will give you a timeline for your case.

When can I return to normal activities after a D&C?

Most patients resume routine activities within a few days, but avoid strenuous work and heavy lifting for about a week. Recovery differs from person to person, and your doctor will advise you based on your progress.

How do I schedule a consultation for D&C at Apollo Hospitals Lucknow?

You can call the Apollo Hospitals appointment helpline on 1860-500-1066, book through the Apollo Hospitals website or the Apollo 24|7 app, or walk in to the reception at the Lucknow hospital. Consultant-specific OPD slots are confirmed at the time of booking.

What should I expect during the recovery process?

Most women have mild cramping and light bleeding for a few days. Follow your post-operative instructions, use pads rather than tampons, and attend fol