Indications for Admission for Dilation and Curettage (D&C)

Clinical Scenarios Requiring Admission for D&C

The European Society of Gynaecological Oncology recommends admission for dilation and curettage (D&C) for patients with atypical hyperplasia/endometrial intraepithelial neoplasia (AH/EIN) or grade 1 endometrioid endometrial cancer (G1 EEC), especially when part of fertility-preserving therapy protocols or when comprehensive evaluation is needed 1, 2, 3
D&C with admission is indicated for patients with suspected endometrial cancer who need comprehensive evaluation, particularly when hysteroscopy is also performed 1, 2
Patients with AH/EIN or suspected G1 EEC requesting fertility-preserving therapy must undergo D&C (with or without hysteroscopy) in specialized centers, which typically requires admission 1, 4
Cases requiring specialist gynaecopathologist confirmation of diagnosis, which may necessitate more extensive tissue sampling under controlled conditions 2, 3

Patients with unstable vital signs or significant comorbidities that increase procedural risk 5
Cases with suspected or confirmed advanced disease requiring comprehensive staging 1, 2
Patients with impaired performance status requiring additional monitoring 2, 3

Patients undergoing D&C as part of damage control surgery for unstable conditions should be admitted for comprehensive management 5
Patients requiring pre-operative optimization before D&C (particularly in emergency settings) should be admitted for stabilization 6

If unstable (hemorrhagic shock, severe anemia, infection) → Admit 5
If requiring specialist pathology review → Consider admission 1, 2
If part of fertility-preserving protocol → Admit to specialized center 1, 3
If for suspected/confirmed endometrial cancer → Admit to specialized center 1, 2