Operations and procedures Flashcards
What is amniocentesis
Sample amniotic fluid from around fetus
Used after 15 weeks
How is amniocentesis performed
Ultrasound guidance
Needle through abdominal wall, into amniotic sac
Avoid passing through placenta
Fetal cells for karyotyping/PCR
What are the indications for amniocentesis
High risk result from 1st trimester screening test
Genetic condition in previous pregnancy
What are the complications of amniocentesis
1% risk of miscarriage
False reassurance
Risk of infection
Pain
Rhesus sensitisation
Increased risk of club foot
What is chorionic villus sampling
Invasive prenatal diagnostic procedure
Performed between 11 and 14 weeks
Biopsy of placental villi
How is chorionic villus sampling performed
Transabdominal/transvaginal
Ultrasound guided
Cannula aspiration/biopsy forceps
Send sample for chromosomal analysis
What are the indications for chorionic villus sampling
High risk from antenatal screening
Previous child with chromosomal/genetic abnormalities
Known carrier for a genetic condition
Family history of a genetic condition
Ultrasound evidence of abnormality
What are the complications of chorionic villus sampling
1% risk of miscarriage
Vaginal bleeding
Pain
Infection
Amniotic fluid leakage
Rhesus sensitisation
What is a hysterectomy
Surgical removal of uterus
What are the 4 types of hysterectomy
Total
Subtotal
Total with bilateral salpingo-oophorectomy
Radical
What is a total hysterectomy
Removal of uterus and cervix
What is a sub-total hysterectomy
Removal of body of uterus
Cervix left behind
What is a total hysterectomy with bilateral salpingo-oophorectomy
Removal of uterus, cervix, fallopian tubes, and ovaries
What is a radical hysterectomy
Removal of uterus, cervix, parametrium, vaginal cuff, and fallopian tubes
Can leave ovaries behind (depending on patient age)
How can a hysterectomy procedure be performed
Abdominally
Vaginally
Laparoscopically
What are the indications for hysterectomy
Heavy menstrual bleeding
Pelvic pain
Uterine prolapse
Gynaecological malignancy
Risk-reducing surgery
Management of major PPH
What are the complications of hysterectomy
Haemorrhage
Infection
Pain
Damaged bladder/uterus/bowel
Wound dehiscence
Pelvic abscess/infection
VTE
Early menopause (change in blood supply to ovary)
When is endometrial ablation usually used
In heavy menstrual bleeding
What are the 4 main techniques of endometrial ablation
Transcervical resection of endometrium (TCRE - uses diathermy)
Balloon ablation (balloon filled with heated fluid)
Microwave energy
Bipolar mesh
Who can not have endometrial ablation
Women who still want to have children
Life-threatening complications if pregnancy does occur
What are the contraindications for endometrial ablation
Women who want to retain fertility
Endometrial hyperplasia
Large uterus
What are the complications of endometrial ablation
Fluid overload
Electrolyte disturbances
Cervical laceration
Uterine perforation
Intrauterine scarring
Haematometra
Pelvic pain
What is tension-free vaginal tape
Synthetic tape, makes a sling around urethra
Used for stress incontinence
What are the complications of tension-free vaginal tape
Bladder perforation
Damage to pelvic blood vessels/viscera
Short term voiding difficulties
Urgency
Frequency
Groin/supra-pubic pain
Erosion of tape
