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Laminaria (right) Osmotic dilators, also known as hygroscopic dilators, are medical implements used to dilate the uterine cervix by swelling as they absorb fluid from surrounding tissue. [1] They may be composed of natural or synthetic materials. A laminaria stick or tent is a thin rod made of the stems of dried Laminaria, a genus of kelp.
Cervical dilation (or cervical dilatation) is the opening of the cervix, the entrance to the uterus, during childbirth, miscarriage, induced abortion, or gynecological surgery. Cervical dilation may occur naturally, or may be induced surgically or medically.
Prostaglandin E 2 (PGE 2) achieves cervical ripening and softening by stimulating uterine contractions as well as directly acting on the collagenase present in the cervix to soften it. [7] There are currently two formulations of PGE 2 analog available for use in cervical ripening: Prepidil, a vaginal gel, and Cervidil, a vaginal insert. [24]
Cervical consistency and position are scored from 0 to 2. The total score ranges with a minimum of 0 and maximum of 13. A Bishop score of 6 and below indicates that induction is not favorable and no method of induction will be highly effective. In these cases, cervical ripening agents may be used.
Dilation and evacuation can be offered for the management of second trimester miscarriage if skilled providers are available. [6] Some women choose D&E over labor induction for a second trimester loss because it can be a scheduled surgical procedure, offering predictability over labor induction, or because they find it emotionally easier than undergoing labor and delivery.
Hegar dilators are used to induce cervical dilation in order to gain entry to the interior of the uterus. During the process of dilation, the cervix may have to be stabilized with a tenaculum , and then the dilators are slowly entered into the cervical canal with a lubricant, starting with a thin, low Hegar number rod and progressing gradually ...
The resulting sample is then sent to a pathology lab for evaluation and diagnosis of cervical cancer. Abnormalities in these samples are similar to those seen in traditional cervical biopsies, and range from reactive squamous and glandular epithelial cells to overt invasive carcinoma. [4] SoftECC
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