Today our topic of discussion is Hysteroscopy of Maternal and Child Health.
Hysteroscopy of Maternal and Child Health
HYSTEROSCOPY
Hysteroscopy allows visualization of the entire endometrial cavity of the uterus. This test is considered to be more effective for viewing and obtaining endometrial pathology than the D and C (dilatation and curettage) or hysterosalpingography.
With D and C, scraping of the endometrial tissue is done without visualization, which may result in failure to harvest the pathologic tissue. With the use of the hysteroscopy, a biopsy could be taken and polyps removed (Fig. 33.4).
Normal Finding
Normal uterine cavity; normal endometrial uterine tissue
Purposes
- To visualize the uterine cavity
- To obtain a biopsy of the endometrial of the uterus
- To remove a uterine polyp.
Client Preparation
- Obtain a signed consent form from the client
- Explain the procedure to the client
- Obtain a menstrual history.
- The test should be performed after menstruation and prior to ovulation
- Explain that discomfort following the carbon dioxide instillation is possible, lower abdominal distention (uterus) and bloating can result.
Procedure
- A consent form should be signed
- Have the client void before the procedure
- The client is placed in the lithotomy position
- A hysteroscope is placed through the cervical os into the endometrial cavity of the uterus.
- Carbon dioxide is usually instilled to distend the uterine cavity
- Biopsy of tissue can be obtained
- The test takes approximately 30 minutes.
Post-procedural Care
- Monitor vital signs
- Check for excessive bleeding or discharge.
Abnormal Findings
- Hyperplasia of the endometrial tissue in the uterus
- Endometrial cancer
- Polyps.
Contraindication
- Cervical or vaginal infections
- Pelvic inflammatory disease or purulent vaginal discharge
- Cervical surgery.
Client Teaching
- Inform the client that cramping may occur following the test. Use of mild analgesic decrease discomfort
- Sexual intercourse of douching should be avoided for 2 weeks or as instructed by the healthcare provider
- Instruct the client to report severe discomfort or shortness of breath immediately to the healthcare provider.
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