Dilation and Evacuation
A safe and effective surgical procedure for second-trimester pregnancy termination or management of mid-trimester pregnancy loss — performed at specialist centres with appropriate expertise and care.
What is Dilation and Evacuation?
Dilation and Evacuation (D&E) is the primary surgical method for second-trimester termination of pregnancy or management of mid-trimester foetal loss. It involves cervical preparation followed by progressive dilation and surgical evacuation of the uterine contents using a combination of suction and forceps. D&E requires specialist training, appropriate anaesthesia, and ultrasound guidance for safe performance. Dr. Ashwani Narla provides comprehensive counselling and care for women requiring second-trimester procedures at Lux Hospitals, Hyderabad, with full pre- and post-operative support.
Suitable for women in the second trimester requiring surgical termination of pregnancy for medical or personal indications, or for management of mid-trimester foetal loss where surgical evacuation is the preferred or safest approach.
How the Procedure Works
Counselling & Cervical Preparation
Pre-procedure counselling is completed and informed consent obtained. Cervical preparation with osmotic dilators or misoprostol is started in advance.
Anaesthesia
General anaesthesia or deep sedation is administered. The patient is positioned and the cervix is assessed for adequate dilation before the procedure begins.
Uterine Evacuation
Suction curettage followed by careful forceps evacuation is performed under ultrasound guidance, ensuring complete removal of all uterine contents.
Completeness Confirmation
Ultrasound confirmation of an empty uterine cavity is performed at the end of the procedure before the instruments are removed.
Recovery & Support
The patient is monitored post-procedure. Rh-immunoglobulin is given if indicated. Contraception counselling and emotional support are offered before discharge.
Outcomes
Who Needs This Treatment?
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Safe and effective surgical management of second-trimester pregnancy loss or termination
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Ultrasound guidance ensures complete evacuation and reduces complication risk
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Cervical preparation reduces the risk of cervical injury and improves procedural safety
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Same-day or overnight procedure with a short recovery period
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Comprehensive counselling and emotional support provided throughout
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Avoids prolonged medical induction which may be emotionally distressing
D&E in the second trimester demands technical skill, compassionate care, and complete attention to the patient's physical and emotional wellbeing — from preparation through to recovery.
— — Dr. Ashwani Narla, Consultant Obstetrician, Gynaecologist & Laparoscopic Surgeon
Dilation and Evacuation Cost in Hyderabad
The cost of dilation and evacuation (D&E) in Hyderabad can vary depending on the gestational age, clinical condition, diagnostic requirements, procedure complexity, anesthesia, and level of hospital care required. D&E is a surgical procedure used in selected second-trimester pregnancy termination cases. The estimated cost generally ranges from ₹40,000 to ₹90,000, with an approximate average cost of ₹65,000.
| Procedure | Approximate Cost Range |
|---|---|
| Dilation and Evacuation for Surgical Abortion – Second Trimester | ₹40,000 – ₹90,000 |
| Dilation and Curettage / Suction Evacuation for Surgical Abortion – First Trimester | ₹25,000 – ₹55,000 |
The actual treatment cost may vary depending on gestational age, medical evaluation, pre-procedure investigations, anesthesia, hospital stay, medications, and any additional care required. Pregnancy termination procedures are subject to applicable legal and medical requirements. Second-trimester procedures may require additional monitoring and hospital care. Anti-D immunoglobulin may be recommended when clinically indicated.
Factors That Influence Dilation and Evacuation Cost
Several factors can affect the overall cost of surgical pregnancy termination:
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Gestational age: The stage of pregnancy can influence the procedure selected, its complexity, and the level of monitoring required.
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Medical evaluation: Ultrasound, blood tests, pregnancy assessment, and other investigations may be required before the procedure.
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Procedure complexity: Second-trimester D&E may involve additional preparation, monitoring, and post-procedure care compared with earlier procedures.
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Anesthesia: The type of anesthesia or sedation required can contribute to the overall treatment cost.
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Hospital stay and recovery: Admission duration, medications, monitoring, and follow-up care may affect the final expenses.
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Additional medical requirements: Treatments such as Anti-D immunoglobulin may be recommended for eligible patients based on blood group and clinical assessment.
Is Dilation and Evacuation Covered by Insurance?
Coverage for D&E depends on the reason for the procedure, applicable regulations, and the patient's health insurance policy. Some medically indicated procedures may be eligible for coverage, while elective or excluded services may not be covered. Patients should confirm eligibility, exclusions, and pre-authorization requirements with their insurer before treatment. The hospital's insurance support team can assist with the required documentation and applicable process.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Ashwani Narla
Consultant Obstetrician, Gynaecologist & Laparoscopic Surgeon
Dr. Ashwani Narla is a Consultant Obstetrician, Gynecologist & Laparoscopic Surgeon at Lux Hospitals, Hyderabad. She provides evaluation and management for various gynecological and pregnancy-related conditions. During the consultation, Dr. Ashwani Narla will assess the patient's gestational age, medical history, symptoms, examination findings, and diagnostic reports. She will explain the medically appropriate options based on the clinical situation and applicable legal requirements. When D&E is considered appropriate, she will discuss the procedure, preparation, possible risks, recovery, and estimated treatment cost based on the patient's individual needs.
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