Managing Complications in Pregnancy and Childbirth: - IAWG

Dilatation and curettageP-63• Evacuate the contents of the uterus with ring forceps or a largecurette (Fig P-34, page P-63). Gently curette the walls of the uterusuntil a grating sensation is felt.FIGURE P-34Curetting the uterus• Perform a bimanual pelvic examination to check the size andfirmness of the uterus.• Examine the evacuated material (page P-67). Send material forhistopathological examination, if required.POST-PROCEDURE CARE• Give paracetamol 500 mg by mouth as needed.• Encourage the woman to eat, drink and walk about as she wishes.• Offer other health services, if possible, including tetanusprophylaxis, counselling or a family planning method (page S-12).• Discharge uncomplicated cases in 1–2 hours.• Advise the woman to watch for symptoms and signs requiringimmediate attention:- prolonged cramping (more than a few days);- prolonged bleeding (more than 2 weeks);- bleeding more than normal menstrual bleeding;- severe or increased pain;