Diaphragm Fitting

DIAPHRAGM FITTING REASON FOR VISIT: • Contraception • Diaphragm insertion RISK ASSESSMENT • Allergy to latex • Allergy to lubricant jelly • PID • Urinary infections ANESTHESIA: None POSITION OF THE PATIENT: Dorsal lithotomy position THE PROCEDURE Diaphragm Fitting • Patient was in the dorsal lithotomy position • The gloved index and middle fingers were inserted into the vagina, aiming for the posterior fornix. • With the middle finger in the posterior fornix, point was noted where the bony inferior pubic arch touches the index finger • The fitting ring/ diaphragm was placed with the rim over the end of the middle finger and the opposite side of the rim extended to the marked position on the index finger. • The rim of the ring/ fitting diaphragm was lubricated

• The device was folded in half • Holding the vulva open with one hand, the folded diaphragm was inserted with other hand into the vagina and to direct placement toward the posterior fornix • The anterior rim was nudged so that it fits directly behind the pubic bone DURATION _____min POSTOPERATIVE CARE • Do not use more than 6 hrs • Maintain proper hygienic conditions COMPLICATIONS • Toxic shock syndrome • Infection • PID • Urinary infection