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Induction Of Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
In 1853, Kraus first described a balloon device for preinduction cervical ripening. A vaginal speculum is often utilized to insert the Foley catheter in the cervical os, but placement via a digital examination is also common. The Foley catheter affects cervical ripening in two ways: (1) gradual mechanical dilation and (2) separation of the decidua from the amnion, stimulating prostaglandin release. Many studies have demonstrated the Foley catheter to be an effective tool for achieving a favorable cervix [45].
Normal labour
Published in Michael S. Marsch, Janet M. Rennie, Phillipa A. Groves, Clinical Protocols in Labour, 2020
Michael S. Marsch, Janet M. Rennie, Phillipa A. Groves
If the membranes have obviously ruptured (e.g. liquor is present at the vulva), but there is no history of contractions, in order to minimize the risk of infection, a vaginal speculum or examination need not be performed. If the diagnosis is uncertain, a speculum examination should be performed. If the diagnosis remains uncertain and the history is strongly suggestive of rupture of membranes (ROM), an ultrasound (US) scan may be arranged to assess liquor volume. However, it must be understood that a normal liquor volume on US does not exclude ROM. An US scan is not necessary if the diagnosis is clear.
Interventional Ultrasound in Diagnosis and Treatment of Female Infertility
Published in Asim Kurjak, Ultrasound and Infertility, 2020
The reported technique is more or less the same and includes examination of patients with full urinary bladders with commercially available real-time ultrasonic equipment. After inserting a vaginal speculum, the vagina and cervix are cleaned with antiseptic solution. A suitable cannula is then inserted inside the cervical canal and the speculum is removed. The ultrasonic probe is placed over the lower abdomen and a baseline transverse scan at the level of the middle uterine part is performed. Isotonic sterile saline solution is then injected into the uterus by means of plastic syringes or pressure pump with pressure not exceeding 80 mm of mercury. It is important to fill the cannula with fluid before instillation to avoid air bubbles. A diagnostic sign of at least one tube patency is the appearance of free fluid in the pouch of Douglas.
Derangements of vaginal and cervical canal microbiota determined with real-time PCR in women with recurrent miscarriages
Published in Journal of Obstetrics and Gynaecology, 2022
Canan Soyer Caliskan, Nazan Yurtcu, Samettin Celik, Ozlem Sezer, Suleyman Sirri Kilic, Ali Cetin
Regarding the limitations of our study, we needed to consider the possibility of contamination during cervical canal sampling, although, before collecting the endocervical specimens, we sterilised the vagina following surgical demands after exposing the cervix using a vaginal speculum and finishing vaginal sampling. Therefore, we needed to keep in mind the possibility of subclinical cervicitis caused by these pathogens, which adversely contributed to the composition of endocervical microbiota. In this study, we found similar detection rates of some microorganisms (Peptostreptococcus spp. and Mycoplasma hominis) due to the evaluation of the rates of microbiological categories (rates of no detection and 0–0.1, 0.1–1, 1–10, and 10–100% TMD or rates of absence, colonisation, and infection) for individual microorganisms with chi-square tests. Not performing the vaginal culture in the participants was another limitation of our study, although no overt vaginal infection was found in the participants with direct microscopy of vaginal smear.
Vaginal collagen I and III changes after carbon dioxide laser application in postmenopausal women with the genitourinary syndrome: a pilot study
Published in Climacteric, 2022
T. L. B. Bretas, M. C. A. Issa, S. C. A. V. Fialho, E. A. G. Villar, L. G. C. Velarde, F. R. Pérez-López
The laser procedures were performed using the fractional microablative FemiLift iPixel CO2 laser (Alma Lasers, Caesarea, Israel). The participants were asked to abstain from sexual activity for 7 days before and after the laser session. There was no need for analgesia or anesthesia. Before treatment, the participant was placed in a dorsal lithotomy position. A vaginal speculum was inserted, and after a quick inspection to rule out any current infection, vaginal secretion was removed with dry gauze. Then, the cylindrical vaginal laser probe with a disposable cover was inserted, allowing the light to irradiate circumferentially throughout most of the vaginal wall. During treatment, the probe was rotated 45° clockwise until it reached the initial 360° position (12:00). It was withdrawn by 1 cm until complete exposition of the probe circumferential marks. The probe was then reinserted, and two more complete passes were performed in each session. The laser was set to medium pulse, 9 × 9 pixels, 2 Hz frequency and 60 mJ energy in the first session, 75 mJ in the second session and 90 mJ in the third session.
How to integrate screening for cervical cancer into grassroots health services for low income countries: An implementation research
Published in International Journal of Healthcare Management, 2021
Ngan T. K. Nguyen, Linh T. Nguyen, Hoang T. Le, Binh T. Nguyen, Nha Ba Pham, Phuong Lan Pham, Lan T. H. Vu
Results indicated that it is feasible to integrate VIA screening into regular reproductive health services provided by CHSs. In term of technical issues, except for acid acetic, all equipment, such as vaginal speculum, is available at the commune health centers. The material cost for a VIA test is available, cheap (about $0.5/person), simple and easy to use. This very low extra cost would not create any burden on increasing insurance cost sharing rate or raising taxes as previous research showed that an increase of 5% cost sharing rate would not have led to change in enrollment [11]. The equipment available, CHSs staffs have used proficiency, no additional investment required, so easy to implement. In particular, the women can register for health insurance at the CHSs. So VIA can offer significant advantages over Pap in low-resource settings, particularly in terms of increased screening coverage, improved follow-up care and overall program quality [12, 13]. Due to the need for fewer specialized personnel and less infrastructure, training, and equipment, with VIA public health systems can offer cervical cancer screening in more remote (and less equipped) health care settings and can achieve higher coverage. Furthermore, providers can share the results of VIA with patients immediately, making it possible to screen and treat women during the same visit. This helps ensure that follow-up care can be provided on the spot and reduces the number of women who may miss out on treatment because they are not able to return to the clinic at another time [13, 14].