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1. Identification and description of the procedure

The diagnostic D&C is a surgical operation that consists in taking endometrial and endocervical materialfor its anatomopathological study, in the cases in which there has been abnormal uterine metrorrhagiaor haemorrhages, it can have a therapeutic value alleviating the copious functional bleeding and orextirpating an endometrial polyp.

It can only be done vaginally and requires anaesthesia that will be administered as the anaesthesiologydoctor deems. All the material obtained will be sent for an anatomopathological study.

2. Purpose of the procedure and benefits that are expected to be achieved

The purpose of this procedure is to clean the interior of the uterine cavity, extracting the remainders thatthe previous gestation may have left. With it, a better uterine fibre contraction is obtained and thehaemorrhages and infections are prevented.

3. Reasonable alternatives to this procedure

Currently we can study the endouterine pathology through a transvaginal ultrasound, sonohysterography,hysteroscopy and cytology through different types of brushing, even though the histological diagnosiscan not be obtained except from and endometrial biopsy with microlegresor with more recent aspirationcannula. For the haemostatic slope of the D&C there are medical alternatives that when the bleeding isvery abundant have little effect.

4. Foreseeable consequences of its performance

The patient will be submitted to the reasonable inherent risks of all anaesthesia and its surgical act. Youwill bleed slightly the first few days alter the D&C. However, a histological report will be derived regardingthe state of the endometrium and in its case a significant decrease of the abnormal bleeding.

5. Foreseeable consequences of its non performance

There will be a continuation or worsening of the present symptoms or the appearance of new ones. It willbe necessary to resort to other diagnostic and/or therapeutic methods.

6. Frequent risks

As the surgical procedure that it is, the diagnostic D&C carries implicit, due to both the technique as wellas the current situation of each patient, a series of common and potentially series complications thatcould require complementary treatment both common as well as surgical.

The complications of the surgical operation in order of frequency can be:

Infections with possible evolution of fever (urinary, endometritis, salpingitis).Haemorrhages with the possibility of blood transfusions (intra or post operative)Perforation of the uterus (especially in atrophied uterus or malignant pathologies)

7. Infrequent risks.

As a surgical procedure there exists a minimal mortality percentage.

8. Risks depending on the patient's clinical situation

The patient must advise of the possible pharmaceutical allergies, coagulation alterations, cardiopulmonaryillnesses or any other or and circumstance that separates her from the norm and which she is aware she

carries.

The patients current health situation in a determined moment can be modified due to: diabetes, obesity,hypertension, anaemia, age etc. And this makes the operation risks modify.

Diagnostic dilation and curettage (D&C)

SPECIA

LITY

ING

YNAECOLOGY

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Diagnostic dilation and curettage (D&C)

SPECIALITY

INGYNAECOLOGY

Declaration of consent

Mr./Mrs./Miss. aged , with home address at, National Identity No. and SIP number

Mr./Mrs./Miss. aged , with home address atacting in the capacity of (the patient's legal representative, relative or close

friend) , with National Identity No.

Hereby declare:

That the Doctor has explained to me that it is advisable/necessary in mysituation to perform a

and that I have adequately understood the information he/she has given me.

In on , 2

Signed: Mr./Mrs./Miss. With National Identity Card No

Signed: Dr. With National Identity Card No

Associate number

Revocation of the consent

I hereby revoke the consent granted on the date of , 2 and I do not wishto carry on with the treatment that I hereby terminate on this date.

In on , 2

Signed: The Doctor Signed: The patient

Associate number: