Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)
CPT4 code
Name of the Procedure:
Insertion of cervical dilator (e.g., laminaria, prostaglandin) (separate procedure)
Summary
Insertion of a cervical dilator is a medical procedure where a device such as laminaria or a prostaglandin agent is placed in the cervix. This helps to gently open and dilate the cervix over time.
Purpose
This procedure is often performed to prepare the cervix before surgical procedures like a dilation and curettage (D&C) or during pregnancy termination. The main goal is to soften and open the cervix to ensure easier and safer access for subsequent procedures.
Indications
- Women undergoing surgical procedures that necessitate cervical dilation.
- Patients requiring cervical preparation for pregnancy termination.
- Those with a medical need for diagnostic access to the uterine cavity.
- Specific obstetric or gynecological conditions requiring cervical softening.
Preparation
- Patients may need to fast for several hours before the procedure.
- Discuss all medications with the healthcare provider; some adjustments might be needed.
- Undergo any necessary pre-procedure tests, such as urine or blood tests.
Procedure Description
- The patient is positioned on an examination table.
- A speculum is inserted to visualize the cervix.
- The cervical dilator, which could be a laminaria stick (a type of seaweed that expands when moist) or a prostaglandin gel, is gently inserted into the cervical canal.
- The speculum is removed, and the patient may rest briefly before going home.
Tools/Equipment:
- Speculum
- Laminaria sticks or prostaglandin gel/suppository
- Sterile gloves
Anesthesia or Sedation:
- Local anesthesia may be used to minimize discomfort.
Duration
The insertion typically takes about 10-15 minutes. The dilator stays in place for several hours to overnight, depending on the desired extent of dilation.
Setting
The procedure is often performed in an outpatient clinic or hospital setting.
Personnel
- Gynecologist or OB/GYN specialist
- Trained nurses or medical assistants
Risks and Complications
- Cramping and mild discomfort.
- Rarely, infection or unintended cervical injury.
- In some cases, bleeding or allergic reaction to the materials.
Benefits
- Gradual and controlled cervical dilation.
- Reduced risk of trauma or complications during subsequent procedures.
- Easier and safer access to the uterine cavity for various medical needs.
Recovery
- Mild cramping and spotting may occur after the procedure.
- Follow-up instructions will include rest, avoiding strenuous activities, and possibly using pain relief medication.
- A follow-up appointment may be necessary to remove the dilator and proceed with the next planned procedure.
Alternatives
Other cervical preparation methods include:
- Mechanical dilators manually adjusted during the surgical procedure.
- Alternative medical agents or oral medications. Pros and cons of these alternatives vary based on patient condition and specific medical needs.
Patient Experience
Patients may feel some discomfort or cramping during insertion and while the dilator is in place. Pain management strategies, including mild pain relievers, can help manage discomfort. Most patients can return to regular activities shortly after the procedure, following medical advice.