Managing Complications in Pregnancy and Childbirth: - IAWG

P-70 Culdocentesis and colpotomyectopic pregnancy and further observations and tests may beneeded (page S-13).• If no fluid is obtained, remove the needle, re-insert it and aspirateagain. If no fluid is obtained, the woman may have an unrupturedectopic pregnancy (page S-13).• If pus is obtained, keep the needle in place and proceed tocolpotomy (see below).COLPOTOMYIf pus is obtained on culdocentesis, keep the needle in place and make astab incision at the site of the puncture:• Remove the needle and insert blunt forceps or a finger through theincision to break loculi in the abscess cavity (Fig P-38);FIGURE P-38Colpotomy for pelvic abscess• Allow the pus to drain;• Insert a high-level disinfected soft rubber corrugated drain throughthe incision;Note: A drain can be prepared by cutting off the fingertips of ahigh-level disinfected rubber glove.• If required, use a stitch through the drain to anchor it in the vagina;• Remove the drain when there is no more drainage of pus.