Discharge And Home Healthcare Guidelines

MEDICATIONS. Be sure the patient and family understand any pain medication prescribed, including dosage, route, action, and side effects.

FOLLOW-UP. Make sure the patient knows all the postprocedure complications. Provide a phone number to call if any complications occur. Ensure that the patient understands the need for ongoing Pap smears if appropriate. Vaginal cytological studies are recommended at 4-month intervals for 2 years, every 6 months for 3 years, and then annually.

DRG Category: 384 Mean LOS: 1.9 days Description: MEDICAL AND SURGICAL: Other Antepartum Diagnoses without Medical Complications

Cervical incompetence, or cervical insufficiency, is a condition in which the cervix spontaneously dilates during the second trimester, or early in the third trimester, of pregnancy, which results in expulsion of the uterine contents. Since this typically occurs in the fourth or fifth month of gestation before the point of fetal viability, the fetus dies unless dilation can be arrested. Incidence of an incompetent cervix has been estimated to be between 0.1% and 2.0% of all pregnancies. The incompetent cervix has abnormal musculature, with an increased proportion of smooth muscle tissue, and this results in a loss of sphincter tone. When the pressure of the expanding uterine contents becomes greater than the ability of the cervical sphincter to remain closed, the cervix suddenly relaxes, allowing effacement and dilation to proceed.

The cervical dilation that occurs with cervical incompetence is typically rapid, relatively painless, and accompanied by minimal bleeding. These features help distinguish the syndrome clinically from other causes of cervical dilation or bleeding, such as preterm labor, placental abruption, and placenta previa.

0 0

Post a comment