you're asleep a speculum is placed inside
the vagina to keep the vaginal walls apart.
The doctor will determine if there has been
sufficient dilation. The doctor will hold
the cervix, the opening to the uterus, with
an instrument called a tenaculum. The physician
will then insert several narrow metal rods,
called dilators, into the cervix to further
open it. The physician uses a slender suction
cannula and other specialized instruments
to remove the pregnancy form the uterus.
The entire process can take 10-20 minutes.
The purpose of laminaria insertion is to
dilate the cervix so that the pregnancy
can be removed. Laminaria are made from
various materials whose purpose is to absorb
water from the cervix and slowly expand
- thereby gently dilating the cervix. It
takes a few minutes for the physician to
insert one or several laminaria and they
may require a few hours or overnight to
effectively dilate the cervix. They are
removed prior to the surgical procedure
when the patient is under general anesthesia.
D&E (Dilatation & Extraction)
This procedure is used for later 2nd trimester
terminations of pregnancy. The cervix has
been dilated with laminaria and/or cytotec
over the course of 1 to 2 days depending
on the necessary dilation. Under general
anesthesia, once adequate dilation is achieved,
all products of conception are removed from
the uterine cavity. This is done as gently
as possible. The procedure takes 5 - 10
minutes and is followed by an ultrasound
inspection to assure that the cavity is
empty. The patient is taken to the recovery
room for approximately 1 - 1 ½ hours.