1. Introduction
2. Confirm the diagnosis
3. Tell the patient indication for the procedure – to remove retained POC
4. Explain the procedure
- this is aseptic procedure
- duration 15-30 minutes
- NBM at least 6 hours before procedure (ask last meal)
- give patient IV drip
- anaesthetist will review patient before operation to choose mode of GA/ regional
- done in operation theatre
- in lithotomy position
- clean and drape
- bladder catheterization
- vaginal examination to see os open/ close
- bimanual examination to know uterus size and position of cervix
- insert Sim’s speculum to visualize the cervix
-Use vulsellum to grab anterior lip of cervix
- insert uterine sound to measure length of uterocervical canal
- if os is closed, dilate with Hegar dilator – use from 3mm – 8mm
- ovum forceps is inserted to remove POC
- use blunt curate to remove POC
-Ask anaesthetist to give IV pitocin 40 unit to make sure uterus is contracted and hard so not easily perforated
- use sharp curate until gritty sensation is felt
- hemostasis secured
-remove vulsellum
-send POC for HPE
- count for estimated blood loss
5. Explain complication to the patient
Short term
- uterus perforate
-Bleeding
-infection
Long term
-adhesion,difficult to conceived
-Asherman syndrome
-placenta previa,placenta accrete
6. Ask patient is she has any enquiries
source: workshop
hanisah A115275
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