Professional Documents
Culture Documents
Module 2 - Session 4
Sharp Curettage
WHO recommends vacuum aspiration as the preferred
method for uterine evacuation before 12 weeks of pregnancy.
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Module 2 - Session 4
Objectives
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Sharp Curettage: Also Known as Dilatation and
Curettage (D&C)
• Sharp curettage (SC) is an effective method for the treatment of
incomplete abortion.
• WHO recommends that sharp curettage be used only when
vacuum aspiration (VA) is not available.
• Reasons why many countries still rely on sharp curettage:
– May experience difficulty in obtaining and maintaining VA
supplies and equipment
– Provider resistance to switching from sharp curettage
– Providers may not have received training in VA
– Some women presenting for PAC services are outside of the
established criteria for VA use
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Sharp Curettage (2)
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Instruments and Supplies for Sharp Curettage
• Sterile equipment:
– Retractor or speculum
– Single-toothed tenaculum or vulsellum
– Graduated dilators
– Uterine sound
– Curette or ring forceps
• Local anesthesia
• Antiseptic solution (e.g., Betadine)
• Sterile gloves and infection prevention supplies/equipment
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Metal Curette
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Steps for Sharp Curettage
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Steps for Sharp Curettage (2)
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Steps for Sharp Curettage (3)
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Steps for Sharp Curettage (4)
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Steps for Sharp Curettage (5)
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Inserting the Retractor and Holding the Anterior
Lip of the Cervix
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Steps for Sharp Curettage (6)
• Curette all quadrants of the uterine cavity until there are signs of
completion.
• Quickly assess tissue for completeness and consistency with
diagnosis.
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Curetting the Uterus
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Steps for Sharp Curettage: Caution!
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Steps for Sharp Curettage—Post-Procedure
Care
13. (Step 13 continued):
– Transfer the patient to a comfortable, monitored recovery area
when she is stable.
– Give paracetamol 500 mg by mouth as needed.
– Take vital signs and check for vaginal bleeding every 15 minutes for
1 hour before discharge from the facility.
– Encourage the woman to eat, drink and walk about as she wishes.
– Offer other health services, as available and appropriate, including
tetanus or malaria prophylaxis. When the patient is fully awake and
alert, inform her of the findings and implications for continued
treatment.
– Continue treatment and monitoring as appropriate to her condition.
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Steps for Sharp Curettage—Post-Procedure
Counseling
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Post-Procedure Care (2)
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Post-Procedure Care Integrating Counseling
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Post-Procedure Care (3)
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