DIAGNOSTIC PROCEDURES.pptx

Diagnostic procedures in the obstetrics and gynaecology includes many methods some of the diagnostic procedures for a women's health physiotherapist should know is included in the above slides

1. DIAGNOSTIC PROCEDURES BY S.CHRISTY SOPNA M.P.Y-II YEAR

2. HYSTEROSALPHYNGOGRAPHY(HSG) Hystero+salpingo+graphy Hystero - uterus salpingo - fallopian tubes Graphy – radiolological procedure

3. INDICATIONS Assessment of tubal patency Detection of uterine malformation Diagnosis of cervical incompetence Detection of translocated IUD Diagnosis of uterine synechiae (adhesions) Diagnosis of uterine fibroid, uterine polyp Diagnosis of abdominal pregnancy Infertility

4. PROCEDURE Anaesthesia given Radio-opaque dye 5-10ml Radiographic x rays TIMING OF PROCEDURE HSG is done D6 and D 10 of cycle Antiobiotics given one day before procedure upto 5 days

5. CONTRAINDICATIONS Suspected pregnancy Acute pelvic infection Active vaginal bleeding Recent dilatation and curettage Immediate pre and post menstrual phase Tubal or uterine surgery within last 6 weeks Contrast sensitivity

6. DILATATION AND CURETTAGE

7. Dilatation and curettage (D&C) Dilatation (widening/opening) Curettage (removal of part of the lining of the uterus or contents of the uterus by scraping and scooping ) TYPES Diagnostic D&C Therapeutic D&C

8. INDICATIONS Abortions Molar pregnancy Prolonged or excessive bleeding Postpartum haemorrhage Anaesthesia General Regional Paracervical – around cervix

9. Complications Uterine perforation Cervical injury Infection Intrauterine adhesions

10. LAPAROSCOPY

11. INTRODUCTION A surgical procedure in which a fibre optic instrument is inserted through the abdominal wall to view the organs in the abdomen or permit small-scale surgery Also known as minimally invasive surgery(MIS) , Keyhole surgery Small incision (usually 0.5-1.5cm) Uses Diagnostic Therapeutic

12. Diagnostic laparoscopy indications Infertility ( status of fallopian tube and adhesions) Ovarian cysts Ectopic pregnancy PID Endometriosis

13. Colposcopy

14. Introduction Colposcopy is a gynaecological procedure that illuminates and magnifies vulva , vaginal walls and uterine cervix Detect abnormalities of these structures

15. Indication If Pap smear is abnormal Cervix looks abnormal Patient with postcoital vaginal bleeding To take biopsy Can also be used for therapeutic procedures

16. HYSTERECTOMY

17. INTRODUCTION HYSTEREC- uterus Tomy – removal Types Subtotal hysterectomy – uterine body only Total hysterectomy – uterine body and cervix Hysterectomy with BSO Radical (or Wertheim) hysterectomy total hysterectomy with pelvic lymph nodes , paracervical tissue and upper 1/3 vagina

18. INDICATIONS Fibroids 30% Endometriosis Uterine prolapse Cancer of the uterus , cervix or ovaries Vaginal bleeding , DUB(dysfunctional uterine bleeding) 20% Uncontrollable PPH

19. ROUTES OF HYSTERCTOMY Abdominal hysterectomy Vaginal hysterectomy Laparoscopic hysterectomy Caesarean hysterectomy