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    Osce - D&C

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    mkct111
    Dilatation and curettage (D&C) is the most common gynecological procedure used to treat dysfunctional uterine bleeding and perform diagnostic or therapeutic uterine scrapings. Key steps include dilating the cervix using dilators like Hagar's or Goodell's, grasping the cervix with a tenaculum forceps, measuring the uterine depth with a hysterometer, and scraping the uterine lining with a curette. The procedure takes approximately 10 minutes under IV sedation and aims to stop bleeding and allow the uterus to contract effectively. Complications can include hemorrhage, sepsis, and trauma.

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    Osce - D&C

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    mkct111
    359 views2 pages
    Dilatation and curettage (D&C) is the most common gynecological procedure used to treat dysfunctional uterine bleeding and perform diagnostic or therapeutic uterine scrapings. Key steps include dilating the cervix using dilators like Hagar's or Goodell's, grasping the cervix with a tenaculum forceps, measuring the uterine depth with a hysterometer, and scraping the uterine lining with a curette. The procedure takes approximately 10 minutes under IV sedation and aims to stop bleeding and allow the uterus to contract effectively. Complications can include hemorrhage, sepsis, and trauma.

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    D & C REVIEWER

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    OSCE - D&C

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    Dilatation and curettage (D&C) is the most common gynecological procedure used to treat dysfunctional uterine bleeding and perform diagnostic or therapeutic uterine scrapings. Key steps include dilating the cervix using dilators like Hagar's or Goodell's, grasping the cervix with a tenaculum forceps, measuring the uterine depth with a hysterometer, and scraping the uterine lining with a curette. The procedure takes approximately 10 minutes under IV sedation and aims to stop bleeding and allow the uterus to contract effectively. Complications can include hemorrhage, sepsis, and trauma.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    359 views2 pages

    Osce - D&C

    Uploaded by

    mkct111
    Dilatation and curettage (D&C) is the most common gynecological procedure used to treat dysfunctional uterine bleeding and perform diagnostic or therapeutic uterine scrapings. Key steps include dilating the cervix using dilators like Hagar's or Goodell's, grasping the cervix with a tenaculum forceps, measuring the uterine depth with a hysterometer, and scraping the uterine lining with a curette. The procedure takes approximately 10 minutes under IV sedation and aims to stop bleeding and allow the uterus to contract effectively. Complications can include hemorrhage, sepsis, and trauma.

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    OBSTETRICS II

    Minor Gynecological Procedures (Dr. Dumaup)


    September 2008

    DILATATION AND CURETTAGE 4. Dilators


    - Most common procedure - Curved
    - For DUB (dysfunctional uterine bleeding) - Insert according to uterine position
    o Diagnostic: determine the cause a. Hank’s dilator
    o Therapeutic: remove layer not shed off (functional o S-shaped
    layer)
    - What is accomplished?
    o Bleeding stops
    o Myometrium contracts effectively
    (interlacing/middle layer)
     Close dilated blood vessels
    - In incomplete abortion b. Hegar’s dilator
    o Completion curettage o Tobacco shaped

    Instruments: Order of Use and Definition


    1. Posterior vaginal retractor
    - To retract posterior vaginal wall
    - To visualize the cervix (inspection)
    c. Goodell’s dilator
    o With adjustments

    2. Tenaculum forcep
    - Sharp teeth on the edge 5. Curette
    - For thick, firm non-pregnant cervix - Inserted when the cervix has already dilated
    - Grasp the lip of the cervix at 12 o’clock position - Scrape endothelial lining
    - Evacuate functionalis layer
    - Not basalis layer (Ashermann’s syndrome)
    o Amenorrhea
    o No regeneration capacity
    o Synechia formation
    - Curette systematically (follow the face of the clock, start
    **For pregnant cervix – use ovum forceps from 12 o’clock to 12 o’clock)
    - Stop when a gritty sensation is felt
    a. Dull/blunt curette

    3. Hysterometer/Uterine Sound
    - Check depth of the uterus to prevent perforation b. Sharp curette
    - A guide for positioning other instruments
    - To know the size of the uterus
    - Has gradations in cm/in
    - Bent – version
    - Position according to bimanual palpation during PE
    - Measure starting from the external OS

    1
    raych_eanne
    OBSTETRICS II
    Minor Gynecological Procedures (Dr. Dumaup)
    September 2008

    6. Uterine forceps - Abortion: gritty sensation + bubbly bleeding


    - Insert vaginal strip into uterine cavity after curettage
    - Turn (to be able to clean the uterus)
    - Remove after use
    - After which, insert vaginal strip with betadine (swab the
    endometrium with antiseptic)

    FRACTIONAL CURETTAGE
    - Uterus and cervix (3 cm)
    - Localize pathology
    *Remove tenaculum forceps - Curette cervical canal with sharp curette before insertion
    - make sure that there is no bleeding upon removal of hysterometer
    - if there is bleeding o To prevent contamination of specimens
    o apply gauze and pressure until the bleeding stops
    COMPLETION CURETTAGE
    *Anesthesia - Evacuate products of conception to prevent sepsis
    - sedation and analgesic - Use OVUM FORCEPS
    - IV - Retract upward
    o Opioid - Stop when
    o Novaine a. Uterus contracts
    - Valium and Demerol b. Decrease blood loss
    - Inhalational anesthesia can also be used c. Gritty sensation
    - It is important to sedate the patient!!
    POSTPARTUM CURETTAGE
    *Difficult to sedate - PLACENTAL CURETTE
    1. Those who drink alcoholic beverages o Big with dull edges
    2. Smokers
    3. Anxious patients
    4. Patients who drank coffee

    ** It is only a 10 minute procedure!!!

    Complications **Kevorkian punch biopsy forceps


    - Hemorrhage - To biopsy cervix
    - Sepsis - Very small piece of tissue
    - Trauma

    ENDOMETRIAL BIOPSY
    - No need to dilate the cervix
    - For infertility work-up
    - No anesthesia need
    - Swab vaginal canal only
    - Submit tissue to histopathology

    1. Posterior wall retractor


    2. Tenaculum forceps
    3. Hysterometer
    4. Kevorkian curette
    - To get endometrial samples
    - Scrapings: anterior first then posterior  lateral 
    fundus
    - Stop when a gritty sensation is felt

    2
    raych_eanne

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