Value of routine dilation and curettage at the time of interval sterilization

Four hundred thirty-four patients underwent tubal ligation at the Beth Israel Hospital during a 27-month period. In 272 cases (62.7%), a dilation and curettage was performed as a routine part of the tubal ligation procedure to ensure that luteal phase pregnancy, if present, would be interrupted. Pathology reports on the curettings from all diagnostic dilation and curettages were reviewed. Evidence of pregnancy was found in seven, but only two (0.8%) proved to be of recent nidation. This series demonstrates that routine dilation and curettage at the time of sterilization may not be cost effective or efficient. Hormonal pregnancy testing, combined with accurate menstrual history and timing the tubal sterilization to occur during the follicular phase, if possible, are proposed as alternatives to operative intervention.