Tool abortion - Causes, Symptoms and Treatment .MF .
operation of induced abortion performed under careful and full anesthesia.Before the operation of induced abortion for operedeleniya size, shape and position of the uterus must be sure to do vaginal examination.
patients after emptying the rectum and the bladder is placed on the examination table, for gynecological surgery.The hair on the vulva should be shaved, the skin is treated with 70% ethyl alcohol and 1% alcoholic solution of iodine.
vagina open mirrors, cotton balls clean it from the discharge.Vaginal mucosa and cervical wiped with 70% alcohol and 1% ethyl alcohol solution of iodine.Doyen forceps or Museo capture cervical anterior lip.Carefully and slowly carried local anesthetic lidocaine 1.2%, particularly in the processing of the cervical canal.Action dikaina easily seen by the increase in the diameter of the external os, by how easy the tool is moving through the channel and enters the cervix into the uterine cavity.Then uterine probe examine the uterus, and specify its length and transver
At 6-7 weeks of pregnancy is enough to treat the cervical canal, as already mentioned, lidocaine, and you can start operation.At 8-9 weeks of pregnancy is necessary to extend the cervical canal, introducing series expanders to Gegara expander number 10-11;at 10-12 weeks of pregnancy - up to №12-13;and some women - up to №14.When performing channel expansion cervical dilator is necessary to coincide with the curvature of the bend of the uterus, otherwise the uterus can be easily perforated.
After expansion into the uterus curette is introduced, which grope fertilized egg destroy it (Figure A), as determined by the expiration of a small amount of water.If curette can not immediately remove the fruit, it is removed aborttsangom.Aborttsang serried introduced into the uterus in its open cavity, they grip the fruit or portion thereof, and removed.After removal of the fetus curette systematically scraped uterine lining, and with it the shell of the ovum.In this case it is not necessary to carry out scraping until the mother clearly audible crunch.After scraping the uterine lining and the remnants of fetal eggs there is a feeling of smoothness of the uterus wall.Once the uterus is emptied, the bleeding stops and you receive the bloody foam, which is an indication for the operation is completed.
should not be with the force of scraping the mucous membrane of the uterine horns, it can lead to obliteration of the intramural portion of the tube.
At a later date, at 13-16 and 18 weeks of pregnancy, life-saving abortion operation can be performed also without much difficulty.The key to the successful implementation of it is thorough anesthesia.Expansion of the cervical canal produce, depending on the duration of pregnancy Gegara expanders, including expanders №16-18, and sometimes the number 20-22.
In the later stages of pregnancy in any case should not start the operation of induced abortion with the destruction of the ovum and curette scraping, this will inevitably lead to severe uterine bleeding.
Once the expansion of the cervical canal is completed, the uterus is administered large aborttsang tearing the membranes (Figure b) without taking aborttsanga after treatment, feel for the most voluminous part of the fetus - head wide open aborttsang and capture them last, withleft hand on the front of the abdominal wall above the bottom of the uterus, the operator con-controlling and corrects movement aborttsanga.Slowly closing aborttsang, crush the head, that can be easily determined by the allocation of brain tissue from the cervical canal.The head must be removed slowly so that her bones did not injure the tissue of the uterus in the internal os.Then, one by one capture and remove the other part of the fruit until it is removed completely.Now the same aborttsangom remove the placenta, and only then gradually curette scrape the uterine lining with the remains of the ovum.All of the fruit must be put into the tray so that you can in case of doubt, check whether the fertilized egg all removed.
therefore, highlights the operation of induced abortion after the preparation of the operative field, and pain relief are as follows:
1) expansion of the cervical canal;
2) removal of the fetus and its membranes aborttsangom or curette (a small period of pregnancy);
3) systematic and careful scraping the uterine lining with the remains of the ovum;
4) Remove the tools with which to perform operations.