Description Speculum examination of the vaginal canal and cervix is a vital part of any gynecologic examination. The use of a speculum also facilitates a number of gynecologic processes, including obtaining cervical cytology or cultures, colposcopy, intrauterine contraceptive device placement…
Description Sonohysterography is a technique for ultrasonographic visualization of the uterine cavity using saline as a contrast and distending media. The technique is also known as saline infusion sonohysterography (SIS). It is well suited for the ultrasonographic detection of endometrial…
Description Pessaries are devices fitted and worn in the vagina to provide support to the pelvic organs. Pessaries are available in various sizes and shapes and are categorized as supportive (eg, ring, lever, Gellhorn, Gehrung, Shaatz) or space occupying (eg,…
Description Cervical conization is a diagnostic or therapeutic procedure that removes a cone-shaped specimen from the uterine cervix. Loop electrocautery excisional procedure (LEEP, also known as large loop excision of the transformation zone [LLETZ]) uses electrosurgical energy instead of a…
Description Removal of an intrauterine contraceptive device (IUD). Indications Elective, desiring a return to fertility or to replace a device after its approved lifespan. IUDs should also be removed in the face of active pelvic inflammatory disease, unrelenting side effects,…
Description Placement of an intrauterine contraceptive device (IUD). Indications Elective, desiring contraception. The IUD is associated with an efficacy rate that is comparable to sterilization and oral contraceptives and may be a particularly good choice for women with diabetes, thromboembolism,…
Description Operative hysteroscopy enables the visual inspection and treatment of intracavitary and submucosal myometrial leiomyomata, which incorporates the use of mechanical or electrosurgical instruments. Indications Known or suspected endometrial polyp(s) or symptomatic intracavitary, submucosal, or intramural leiomyomata where there is…
Description Diagnostic hysteroscopy describes a number of techniques that allow the direct inspection of the endometrial cavity, endocervix, and fallopian tube ostia. Indications Dysfunctional uterine bleeding, postmenopausal bleeding, menorrhagia, abnormal endometrial thickening documented by ultrasonography, retained intrauterine contraceptives or other…
Description Forceps-aided birth is a method of assisting or expediting vaginal vertex birth through the application of obstetric forceps. Operative vaginal birth can be faster and safer than cesarean birth in many cases. There is a greater chance of success…
Description External cephalic version is the process used to move a malpositioned fetus into the vertex position by external means. This is performed on the nonlaboring patient near term (≥37 0/7 weeks) to improve the chance of vaginal delivery. Indications…