Chapter 10 – Pregnancy Options

Surgical abortion

Methods and timing of surgical abortion

Surgical abortion involves inserting a small plastic tube through the cervix to remove the lining and contents of the uterus by applying suction. Most surgical abortions are performed under IV sedation or ‘twilight sleep’. There may also be the option of having a local anaesthetic only or a general anaesthetic, depending on the setting.

There are two recommended methods for first trimester surgical termination of pregnancy; electric vacuum aspiration (EVA) and manual vacuum aspiration (MVA). Dilatation and curettage is no longer recommended for abortion.(15)

Electric vacuum aspiration (EVA) is commonly used for termination of pregnancy in the first trimester up to 14 weeks. At 12-14 weeks larger tubing and forceps may also be required. Manual vacuum aspiration (MVA) can be used in the first trimester; some providers recommend it only to 10 weeks. It is useful for procedures done under local anaesthetic as it is quieter and may be less painful.(16) MVA is widely used in low resource settings as it is economical.

Surgical abortion is often delayed until 6 weeks gestation due to the risk of missing a very tiny early pregnancy when evacuating the uterine contents.

Cervical ripening agents, such as misoprostol, may be used orally or ... Buy now

Complications of surgical abortion

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Expected process of surgical abortion

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Management of complications following surgical abortion in primary care

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