When to do cervical curettage

Cervical diseases are very troublesome for women. Because the cervix is ​​very private and difficult to clean, some women do not clean the cervix very well. However, if there is a more serious disease in the cervix, it needs to be treated. Cervical curettage is one method. So, under what circumstances should cervical curettage be performed?

Overview

Its incidence rate has been on the rise in recent years. Depending on the location of the fertilized egg implantation, it can be divided into fallopian tube pregnancy, ovarian pregnancy, abdominal pregnancy, rudimentary uterine horn pregnancy, cervical pregnancy, etc. Among them, tubal pregnancy is the most common, accounting for about 95% to 97%. In tubal pregnancy, the fertilized egg can implant in any part of the fallopian tube, such as the fimbria, ampulla, isthmus, interstitial part, etc. Among them, ampulla pregnancy is the most common.

Ectopic pregnancy is treated with surgeries such as salpingectomy, salpingo-oophorectomy, conservative tubal pregnancy surgery, blood clot removal for old tubal pregnancy, embryonic sac removal for abdominal pregnancy, rudimentary uterine horn pregnancy removal, and cervical canal incision and repair, depending on the location of the pregnancy, rupture, and patient condition. In recent years, tubal pregnancy surgery has been performed mostly under laparoscopy.

Cervical pregnancy is a rare and dangerous ectopic pregnancy in which the fertilized egg implants and develops in the cervical canal.

Indications

Endocervical curettage is suitable for those who are less than 12 weeks pregnant, have little bleeding, and are in a relatively stable condition.

Contraindications

The embryo is large and there is active bleeding.

Preoperative preparation

Prepare enough blood and be prepared for shock rescue.

Anesthesia and positioning

With or without local anesthesia, the patient takes the lithotomy position.

Surgical procedures

1. Disinfection of the vulva, vagina and cervix.

2. Suture and ligate the descending branch of the uterine artery next to the cervix.

3. Scrape the cervical canal to remove embryonic tissue. If it is difficult to clear and there is active bleeding, stop scraping immediately, pack the cervical canal with iodoform gauze, and use MTX or 5-FU chemotherapy at the same time. If conditions permit, it can be performed under B-ultrasound guidance.

Chemotherapy can cause the embryonic tissue to degenerate, necrotize, and fall off naturally. The necrotic tissue can also be removed by scraping after chemotherapy.

Points to note during surgery

Operate accurately and quickly, avoid excessive scraping, and minimize blood loss.

Postoperative care

After cervical curettage, pay attention to vaginal discharge and cervical recovery.

complication

The patient suffered hemorrhagic shock, mainly due to the failure to promptly control heavy bleeding at the implantation site of the fertilized egg in the cervix.