assalamualaikum..

alhamdulillah...tamat sudah pengajian di IPGKSM, Besut.. terlalu banyak pahit manis dalam mencapai segengam diploma perguruan. Moga ilmu yang diperoleh akan dapat dimanfaatkan sebaik mungkin dalam pengajaran khususnya dan dalam kehidupan, am nya..
well..bukan senang untuk senang..untuk mendapat jawatan TETAP dalam sangat perlukan PENGORBANAN...
terlalu banyak PENGORBANAN terpaksa dilakukan. Namun demi masa depan ank cucu, aku gagahkan jua.
kelas bermula pada 26 mei hingga 9 jun..
final xm..8&9 jun..kelakar pun ada..selepas 4thn xmsk dewan tuk jawab xm..
xtdo lena gak..
kena study punya lah bykkkkkkkkkk..xtau nak baca apa...mmg nek penim lah.. namun alhamdulillah... ada yg boleh aku jawab even xbrape nk confident..moga xdak masalah lah dgn segala jawapan yg aku tulis tuh..ngeh3...
tapiiiiiiiiiiiiiiiiiiiiii...dalam duk kalut nak xm sempar lg lah aku dgn my cousin a.K.a classmate aku dan kawan ku pergi ker kole besut..
perghhhhhhhhhhhhhhhhhhhhhhhhhhhhh.... HUGE hokay...mcm2 benda jual kt ctu.. yg xdak cuma lah MAK&AYAH + adek beradek.. suami pun xdak..hihihi...
penat ronda kawasan tuh dgn my cousin...hua3..smpi terduduk d btnya.. dgn cuaca yg sgt2 hot ari tuh...yg xleh blah kami berdua just beli buah manggis..hahaha..sbb mmg xtau nak beli apa..rambang mata d bt nya..semua nak beli...
hebat kan...dalam duk kalut nk xm tuh...keh3..p ronda merata..
xpe lah..xtau bila plak blh p kole besut..tgu hubbyku blk lah tp dia weekend sabtu dan ahad.. mana ada dh pasar kole besut tuhh...
im going to miss that place..hope someday i can live at that place..
in Shaa ALLAH..moga permohonan suamiku utk posting ke gong kedak termakbul and me toooooooooooo...moga my posting to tadika yitr cawangan kg.raja, besut...will APPROVED ...amin

apa lagi nk tulis eik..smpi cni dulu,,6t nk tulis lagi..hik3

assalamualaikum wbt...
long time i'm not wrote here...
hurmmmmmmmmmmmmmmmmm.... 7 months after my marriage...
i found that i'm pregnant...
such a wonderfull moment...
but its not so long...
7 weeks pregnancy doc ask me to go to the hospital 4 d&c..
all my dreams to become a mommy just go like that...
on April 13...my baby not with me anymore....
now aku kena berpantang..
masa aku taip nih...br 10 ari berpantang...kehilangan ank sgt menyakitkan... sbb dh lama aku nantikan kehadirannya dalam hidup aku...
tQ ALLAH sebab sudi pinjamkan even sekejap sgt dlm rahimku ini...

now,,,lets check it out,,
what is d&c

Dilation and curettage

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**Dilation and curettage**
(D&C)
Background
Abortion type	Surgical
First use	Late 19th century
Gestation	4-12 weeks
Usage
WHO recommends only when manual vacuum aspiration is unavailable
United States	1.7% (2003)
Medical notes
Undertaken under heavy sedation or general anesthesia. Risk of perforation. Day-case procedure
Infobox references

Dilation (or dilatation) and curettage (D&C) refers to the dilation (widening/opening) of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping (curettage). It is a therapeutic gynecological procedure as well as a rarely used method of first trimester abortion.^[1]^[2]

D&C normally refers to a procedure involving a curette, also called sharp curettage.^[1] However, some sources use the term D&C to refer more generally to any procedure that involves the processes of dilation and removal of uterine contents, which includes the more common suction curettage procedures of manual and electric vacuum aspiration.^[3]

[hide]

[edit] Procedure

An illustration of a dilation and curettage

The first step in a D&C is to dilate the cervix, usually done a few hours before the surgery. The woman is usually put under general anesthesia before the procedure begins. A curette, a metal rod with a handle on one end and a sharp loop on the other, is inserted into the uterus through the dilated cervix. The curette is used to gently scrape the lining of the uterus and remove the tissue in the uterus. This tissue is examined for completeness (in the case of abortion or miscarriage treatment) or pathologically for abnormalities (in the case of treatment for abnormal bleeding).^[1]

[edit] Clinical uses

D&Cs are commonly performed for the diagnosis of gynecological conditions leading to 'abnormal uterine bleeding';^[4] to resolve abnormal uterine bleeding (too much, too often or too heavy a menstrual flow);^[2] to remove the excess uterine lining in women who have conditions such as polycystic ovary syndrome (which cause a prolonged buildup of tissue with no natural period to remove it);^{[citation
needed]} to remove tissue in the uterus that may be causing abnormal vaginal bleeding,^[1] including postpartum retained placenta;^[5] to remove retained tissue (also known as retained POC or retained products of conception) in the case of a missed or incomplete miscarriage;^[3] and as a method of abortion that is now uncommon.^[1] In contrast, D&C remains 'standard care' for missed and incomplete miscarriage in many countries despite the existence of alternatives currently used for abortions.

Because medical and non-invasive methods of abortion now exist, and because D&C requires heavy sedation or general anesthesia and has higher risks of complication, the procedure has been declining as a method of abortion. The World Health Organization recommends D&C as a method of surgical abortion only when manual vacuum aspiration is unavailable.^[6] According to the Centers for Disease Control and Prevention, D&C only accounted for 2.4% of abortions in the United States in the year 2002,^[7] down from 23.4% in 1972.^[8] Most D&Cs are now carried out for miscarriage management and other indications such as diagnosis.

Hysteroscopy is a valid alternative to D&C for many surgical indications from diagnosis of uterine pathology to the removal of fibroids and even retained products of conception. It poses less risk because the doctor has a view inside the uterus during surgery, unlike with blind D&C.

Medical management of miscarriage and medical abortion using drugs such as misoprostol and mifepristone are safe, non-invasive and cheaper alternatives to D&C.

[edit] Complications

Complications may arise from either the introduction or spreading of infection, adverse reaction to general anesthesia required during the surgery or from instrumentation itself, if the procedure is performed blindly (without the use of any imaging technique such as ultrasound or hysteroscopy).

One risk of sharp curettage is uterine perforation. Although normally no treatment is required for uterine perforation, a laparoscopy may be done to verify that bleeding has stopped on its own. Infection of the uterus or fallopian tubes is also a possible complication, especially if the woman has an untreated sexually transmitted infection.^[1]

Another risk is intrauterine adhesions, or Asherman's syndrome. One study found that in women who had one or two sharp curettage procedures for miscarriage, 14-16% developed some adhesions.^[9] Women who underwent three sharp curettage procedures for miscarriage had a 32% risk of developing adhesions.^[9] The risk of Asherman's syndrome was found to be 30.9% in women who had D&C following a missed miscarriage,^[10] and 25% in those who had a D&C 1–4 weeks postpartum.^[11]^[12]^[13] Untreated Asherman's syndrome, especially if severe, also increases the risk of complications in future pregnancies, such as ectopic pregnancy, miscarriage, and abnormal placentation (e.g.placenta previa and placenta accreta).^[1] According to recent case reports, use of vacuum aspiration can also lead to intrauterine adhesions.^[14]

[edit] See also

[edit] References

^ ^a ^b ^c ^d ^e ^f ^g "Dilation and sharp curettage (D&C) for abortion". Women's Health. WebMD. 2004-10-07. Retrieved 2007-04-29.
^ ^a ^b Hayden, Merrill (2006-02-22). "Dilation and curettage (D&C) for dysfunctional uterine bleeding". Healthwise. WebMD. Retrieved 2007-04-29.
Nissl, Jan (2005-01-18). "Dilation and curettage (D&C) for bleeding during menopause". Healthwise. WebMD. Retrieved 2007-04-29.
^ ^a ^b "What Every Pregnant Woman Needs to Know About Pregnancy Loss and Neonatal Death". The Unofficial Guide to Having a Baby. WebMD. 2004-10-07. Retrieved 2007-04-29.
^ Anastasiadis PG, Koutlaki NG, Skaphida PG, Galazios GC, Tsikouras PN, Liberis VA. (2000). "Endometrial polyps: prevalence, detection, and malignant potential in women with abnormal uterine bleeding.". Eur J Gynaecol Oncol. 21 (2): 180–183. PMID 10843481.
^ Wolman I, Altman E, Fait G, Har-Toov J, Gull I, Amster R, Jaffa A. (2009). "Evacuating retained products of conception in the setting of an ultrasound unit.". Fertil Steril. 91 ((4 Suppl)): 1586–88. doi:10.1016/j.fertnstert.2008.10.032. PMID 19064261.
^ "Dilatation and curettage". A-Z Managing Complications in Pregnancy and Childbirth by WHO. Retrieved February 20, 2006.
^ "Abortion Surveillance --- United States, 2002". MMWR Surveillance Summaries. Retrieved February 20, 2006.
^ "Abortion Surveillance -- United States, 1990". MMWR Surveillance Summaries. Retrieved February 20, 2006.
^ ^a ^b Friedler S, Margalioth EJ, Kafka I, Yaffe H (1993). "Incidence of post-abortion intra-uterine adhesions evaluated by hysteroscopy--a prospective study". Hum. Reprod. 8 (3): 442–4. PMID 8473464.
^ Schenker JG, Margalioth EJ (1982). "Intra-uterine adhesions: an updated appraisal.". Fertility Sterility 37 (5): 593–610. PMID 6281085.
^ Kodaman P, Arici A (2007). "Intrauterine adhesions and fertility outcome:how to optimize success?". Curr Opin Obstet Gynecol 19 (3): 207–214. doi:10.1097/GCO.0b013e32814a6473. PMID 17495635.
^ Rochet Y, Dargent D, Bremond A et al. (1979). "The obstetrical outcome of women with surgically treated uterine synechiae (in French).". J Gynecol Obstet Biol Reprod 8 (8): 723–726. PMID 553931.
^ Buttram VC, Turati G (1977). "Uterine synechiae: variations in severity and some conditions which may be conducive to severe adhesions". Int. J. Fertil. 22 (2): 98–103. PMID 20418.
^ Dalton VK, Saunders NA, Harris LH, Williams JA, Lebovic DI (2006). "Intrauterine adhesions after manual vacuum aspiration for early pregnancy failure.". Fertil. Steril. 85 (6): 1823.e1–3. doi:10.1016/j.fertnstert.2005.11.065. PMID 16674955.

[edit] External links

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Methods	Vacuum aspiration · Dilation and evacuation · Dilation and curettage · Intact D&X · Hysterotomy · Instillation · Menstrual extraction · Abortifacient drugs ( Mifepristone · Misoprostol ) · Unsafe abortion

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Female genital surgical and other procedures (gynecological surgery) (ICD-9-CM V3 65–71, ICD-10-PCS 0U)

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