6. UTERINE ASPIRATION PROCEDURE

^{Updated June 2022 by Lara Crystal-Ornelas MD, Vanessa Ramirez MD, Aisha Wagner MD}

This section contains information on first trimester uterine aspiration with manual and electric vacuum, used for both abortion and early pregnancy loss (EPL) management. You will have the opportunity to train in the use of vacuum equipment, steps in the uterine aspiration procedure, and tissue evaluation. Although most early uterine aspiration procedures are technically straightforward, some present challenges. Management of complex cases and complications will also be discussed.

CHAPTER LEARNING OBJECTIVES

Following chapter completion and hands-on experience, you should be able to:

• Approach communication, pelvic exams, and care with a trauma-informed lens 
• Consistently use the ‘no touch technique’ while providing uterine aspiration, and describe its importance
• List the steps of the uterine aspiration procedure and tips for cervical dilation
• Correctly use equipment for manual and electric uterine aspiration
• Evaluate products of conception for presence of appropriate gestational tissue
• Assess and manage challenges and complications related to uterine aspiration

VIDEOS / SIMULATIONS

• Procedural simulation papaya workshops:
  • TEACH: t.ly/ra1_U
  • RHAP: http://goo.gl/zvOxyn
• Managing complications
  • IERH Managing Complications of Procedural Abortion: https://bit.ly/3MUgxlZ
  • TEACH Managing Hemorrhage Simulation Workshop: t.ly/ra1_U

TEACH Simulation Practice Scenarios: t.ly/ra1_U

READINGS / RESOURCES

• Paul et al (eds). Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care (Wiley-Blackwell, 2009)
  • Chapter 10: First Trimester Aspiration Abortion
  • Chapter 13: The Challenging Abortion
  • Chapter 15: Surgical Complications: Prevention and Management
• World Health Organization 2022 Abortion Care Guidelines: https://bit.ly/3sOpXas