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Sometimes a dilation and curettage procedure is necessary to remove any remaining fetal or placenta tissue. [2] Instillation methods can require hospitalization for 12 to 48 hours. [2] In one study, when laminaria were used to dilate the cervix overnight, the time between injection and completion was reduced from 29 to 14 hours. [3]
During dilation, this plug is loosened. It may come out as one piece, or as thick mucus discharge from the vagina. When this occurs, it is an indication that the cervix is beginning to dilate, although not all women will notice this mucus plug being released. Bloody show is another indication that the cervix is dilating. Bloody show usually ...
Dilation (or dilatation) and curettage (D&C) refers to the dilation (widening or opening) of the cervix and surgical removal of sections and/or layers of the lining of the uterus and or contents of the uterus such as an unwanted fetus (early abortion before 13 weeks), remains of a non-viable fetus, retained placenta after birth or abortion as well as any abnormal tissue which may be in the ...
Most abortion providers use laminaria, Dilapan-S, or both for osmotic dilation prior to surgical abortion after 16–18 weeks gestation. [ 7 ] Osmotic dilators may also be used to achieve cervical dilation prior to gynecology procedures, such as hysteroscopy or dilation and curettage of the non-pregnant uterus, [ 8 ] although this is uncommon.
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.
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Intact dilation and extraction (D&X, IDX, or intact D&E) is a surgical procedure that terminates and removes an intact fetus from the uterus. The procedure is used both after miscarriages and for abortions in the second and third trimesters of pregnancy. When used to perform an abortion, an intact D&E can occur after feticide or on a live fetus.
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 to larger numbers. [13] The dilators can also be used to sound the uterus.