9.4 Digital curettage


Use of finger(s) to remove placental fragments or blood clots detected late after an abortion or delivery, when insufficient cervical dilation renders uterine exploration impossible (the cervix must however be sufficiently open to allow insertion of one finger, two if possible).

9.4.1 Indications

– Delayed detection of haemorrhagic abortion or retained placenta, where uterine exploration cannot be performed.

9.4.2 Technique

Figure 9.2 - Exploration of the uterus with two fingers

– Follow precautions common to all intrauterine procedures (Section 9.1.1) and specific precautions for manual procedures (Section 9.1.2).
– Insert the index finger, and the middle finger if possible, into the uterine cavity; cup the uterus through the abdomen with the other hand.
– Systematically explore and remove any remaining fragments.