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Dilatation and curettage
This document describes the instruments and procedures involved in dilation and curettage (D&C). It explains that D&C involves dilating the cervix and then scraping the uterine lining using curettes. It provides details on the specific instruments in a D&C tray, including speculums, retractors, forceps, dilators, curettes, sounds, and spatulas. Each tool is defined and its uses in procedures like D&C, IUD insertion and removal, and examining the cervix and vagina are outlined.
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Dilatation and curettage
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- 2. WHAT IS D&C Dilation(or dilatation) and curettage refers to the dilation(widening/opening) of the cervix and surgical removal of part of the lining of the uterus or contents of the uterus by scraping and scooping(curettage) Mostly used in first trimester miscarriage or abortion.
- 3. D&C TRAY Spongeholding-2 Sims vaginal speculum. Sims vaginal wall retractor. Cusco`s vaginal speculum. Vulsellum forceps 2 Cervical dilator(Hegar`s dilator). Sims uterine curette Ayre`s spatula. Uterine sounds.
- 4. SIMS VAGINAL SPECULUM Used for exposing and inspecting the vaginal wall and cervix. For collecting discharge from vagina and cervix for microscopy Used in D&C ,IUCD insertions etc. To detect vesicovaginal fistula, vaginal wall prolapse like cystocele, enterocele etc To detect cervical carcinomas and its different diagnosis.
- 6. Sims vaginal wallretractor Used to retract the lax vaginal wall to expose the cervix. To visualize cervix , cystocele and growth on vagina. To visualize site of fistula like vesico vaginal fistula etc. Can be rarely used as a curette to remove the retained bits of placenta.
- 8. Vulsellum forceps Vulsellumforcep has multiple sharp teeth at the end which, when locked , give a firm grip on the cervix 20 cm in length, curved or straight Used to grasp or hold the anterior lip of the cervix in operations. To steady the cervix to get firm grip on cervix so as to pass any instrument inside the uterus during procedure like D&C. To determine the degree of uterine prolapse.
- 10. Uterine sounds Todetermine the uterocervical length,position of uterus Used in diagnosis of cervical elongation. To determine the location of the displaced intrauterine contraceptive device(IUCD). Used to diagnose cervical stenosis. Used to drain pyometra in case of carcinoma cervix/endometrium.
- 12. Cervical dilator(HEGAR`S DILATOR) They are double ended or single ended metal dilators with a suitable curve for the uterocervical canal in pregnant uterus. Used mainly in obstetrical indications Used to dilate the internal os of the cervix in cases of abortion or in medical termination of pregnancy for suction and evaculation. Used to dilate the cervix during the LSCS for the draining of lochia.
- 14. Cusco`s vaginal speculum Self retaining retractor It causes least discomfort during the introduction. It gives good exposure as it can be adjusted to the size of the vagina. Used for inspection of vagina and cervix. Useful in pap smear, cervical biopsy, high vaginal swab etc.
- 16. Sims uterine curette The ends of the curette may be blunt and sharp or both ends sharp or both blunt Loops are of various sizes-small ,medium, large. USES OF SHARP CURETTE Used for gynecological conditions for both diagnostic and therapeutic purposes In DUB(dysfunctional uterine bleeding) for histopathology of endometrium. Used in suspected cases of tuberculous endometritis. In patients with postmenopausal bleeding. Used before certain operations like fothergill`s operation.
- 17. USES OF BLUNTCURETTE Mainly used in obstetrical conditions Used to curette retained bits of products in incomplete abortion. Used to curette the retained bits of placenta
- 19. Ayer`s spatula Madeup of wood or plastic One end is rounded and the other end is used for scraping squamocolumnar junction. Used to take smear directly from the cervix or pap smear. Used for screening of carcinoma cervix.
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