Aim: Dilatation and curettage (D&C) is a common day-care procedure in obstetrics and gynecology, with patients discharged after a brief hospital stay on the same day of the surgery. Although it has a short duration, severe pain occurs during the procedure. Therefore, this surgical procedure requires an anesthetic to provide adequate analgesia, rapid onset, and rapid recovery. The main objective of the present study was to compare the analgesic effectiveness and safety of tramadol with those of fentanyl during D&C.
Methods: The study comprised 100 women with American Society of Anesthesiologists classification I-II who were scheduled for a D&C procedure. Baseline anesthesia was maintained with 1 mg/kg propofol, and the patients were then randomly allocated to receive tramadol 1 mg/kg (Group T, n = 50) or fentanyl 1 μg/kg (Group F, n = 50). Hemodynamic variables, sedation, pain, the Aldrete recovery score, and side-effects were recorded.
Results: SpO₂ levels in Group F in the 5th min and at the end of the procedure were significantly lower than those in Group T (P = 0.024 and 0.021, respectively).
Conclusion: Tramadol provides similar analgesic efficacy to fentanyl. Furthermore, tramadol may provide better respiratory stability in patients undergoing a D&C procedure.
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http://dx.doi.org/10.1111/jog.12259 | DOI Listing |
Int J Gynaecol Obstet
January 2025
Department of Obstetrics and Gynaecology, Aga-Khan University of Hospital, Nairobi, Kenya.
Placenta accreta spectrum (PAS) poses a significant risk for maternal morbidity and mortality. There is a global rise in incidence of PAS in tandem with an increase in rates of cesarian section. Previous cesarian section and presence of placenta previa are two independent risk factors for development of PAS.
View Article and Find Full Text PDFJ Gynecol Oncol
January 2025
Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Objective: To determine the accuracy of aspiration biopsy (AB), hysteroscopic biopsy (HB), and dilatation & curettage (D&C) in detecting uterine carcinosarcoma (UCS).
Methods: Pathology reports were retrieved from the Dutch Nationwide Pathology Databank PALGA for patients with a certain or suggested diagnosis of UCS in pre- and/or postoperative histology between 2001 and 2021. Patients without available pre- or postoperative pathology reports were excluded.
J Obstet Gynaecol Res
January 2025
Core Laboratory, Tianjin Beichen Hospital of Nankai University, Tianjin, China.
Cervical dilatation, uterine evacuation, and curettage (D&E&C) are common gynecological procedures for abortion, yet they carry risks of complications such as uterine perforation and intra-abdominal organ incarceration. Here, we report a rare case of a breastfeeding patient who had an embedded abdominal greater omentum in the anterior wall of the uterus and into the uterine cavity during D&E&C. We used combined hysteroscopic and laparoscopic treatment for this case and successfully removed the embedded greater omentum.
View Article and Find Full Text PDFTaiwan J Obstet Gynecol
January 2025
Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:
Objective: Primary endometrial squamous cell carcinoma (PESCC) is an extremely rare type of endometrial cancer with limited research and understanding. This report presents a case of PESCC and reviews 37 cases from 1997.
Case Report: A 61-year-old menopausal woman presented with abnormal vaginal bleeding.
J Obstet Gynaecol Res
January 2025
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Aim: While manual vacuum aspiration (MVA) is commonly employed for early first-trimester abortions, its effectiveness in treating hydatidiform mole is still unclear. This study sought to evaluate the efficacy and safety of MVA in comparison to dilation and curettage (D&C) for managing hydatidiform mole.
Methods: We conducted a retrospective review of medical records for 198 patients with hydatidiform mole treated at Nagoya University Hospital between 2004 and 2023.
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