Friday, February 25, 2011

Consent for Dilatation & curettage

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



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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