- Manual Vacuum Aspiration Procedure
- Manual Vacuum Aspiration Steps For Adults
- Manual Vacuum Aspiration Procedure Note
- Manual Vacuum Aspiration Steps For Sale
First Trimester Uterine Aspiration Manual Vacuum Simulation. Simulators to be used. A ripe medium or large papaya (Note: cantaloupe can also be substituted). O Poke a hole in the stem of the papaya with a uterine soundto c reate a cervical os in each papaya. A large plastic or paper cup to have papaya sit in (optional).
In This Article
Continued Vacuum Aspiration (Suction Abortion) Most abortions done in the U.S. Take place in the first 12 to 13 weeks of pregnancy. If you opt for an in-clinic abortion in your first trimester. Manual vacuum aspiration has improved the provision of early abortion because it allows for removal of an intact gestational sac, easing tissue examination compared with conventional suction abortion. It is less noisy than electric vacuum aspiration and may also improve satisfaction for the patient undergoing abortion without sedation. What Is Vacuum Aspiration? This abortion procedure now used in many clinics is the safest and least traumatic available. The three main steps involved are: 1) an injection, to numb the cervix, 2) the insertion of a small flexible plastic cannula (sterile tube) through the natural opening to the uterus (the cervix), and 3) removal of the pregnancy by suction, which is created by an aspiration.
Manual Vacuum Aspiration Procedure
Table of Contents
- What to Expect
- Recovery
- Effectiveness
The early abortion machine vacuum aspiration procedure is one of three available options to end an early pregnancy (the abortion pill and manual aspiration are the other methods). This early abortion method can be used 5 to 12 weeks after your last menstrual period.
This procedure is quick (5 to 15 minutes) and can be safely completed in a regular medical office or clinic.
Manual Vacuum Aspiration Steps For Adults
Machine Vacuum Aspiration Also Known As
- Early abortion
- Aspiration abortion
- Machine vacuum aspiration
- Vacuum aspiration
Before the Procedure
- An osmotic (cervical) dilator may be inserted into the cervix to slowly dilate its opening either a day before or hours before a machine vacuum aspiration abortion.
- Misoprostol may be given to help soften the cervix.
- Pain or sedation medication might be provided orally or intravenously. Vasopressin (or a comparable medication) could also be mixed with the local anesthetic to lessen or slow bleeding at the injection site on the cervix.
During the Procedure
- Your doctor will insert a speculum.
- The cervix will be cleaned with antiseptic and numbed with a local anesthetic.
- The uterus is held in place with an instrument that grasps the cervix. The cervix is then dilated to reduce the risk of injury to it.
- A hollow tube, called a cannula, is inserted into the cervix. It is attached by tubing to a bottle and a pump.
- When the pump is turned on, it creates a gentle vacuum that suctions the tissue out of the uterus.
During this time, you may feel mild to moderate cramping because of your uterus contracts when the tissue is removed. There is some discomfort, yet the cramping should lessen once the cannula is taken out. You also might feel faint, sweaty or nauseous.
After the Aspiration Abortion
- After a machine vacuum aspiration abortion, the removed tissue may be examined to make sure that all of it has been taken out, and the abortion is complete.
- Based on how you are feeling, you can usually resume normal activities the next day. You will probably need to wait about a week for sexual activity or to use tampons.
Possible Side Effects
- After the procedure, you will most likely be bleeding, though there tends to be less bleeding after the aspiration procedure than with the use of the abortion pill. (The bleeding is lighter than a typical period). You could also have some spotting for the first two weeks.
- You may be prescribed antibiotics to prevent infection.
- You could also experience more cramps that may occur for a few hours (after the aspiration procedure) to maybe even a few days (as your uterus is shrinking back to its normal size). Your doctor may suggest acetaminophen or ibuprofen relieve this cramping.
Effectiveness
The aspiration procedure is approximately 98-99% effective. Yet, in rare cases, an aspiration procedure may not end a pregnancy. This is more likely to occur in manual aspirations performed before 6 weeks, where about 3% fail and require a repeat procedure.
If all of the tissue has not been successfully removed during a machine vacuum aspiration, a dilation and curettage (D&C) proceduremight be needed.
Final Thoughts
- Machine vacuum aspiration abortion is safe for future pregnancy, as there is the minimal possibility of developing scar tissue.
- This procedure is typically safe, effective and has a low risk for complications.
- Minor complications that could occur include injury to the uterine lining or cervix or infection.
- Keder LM. 'Best practices in surgical abortion.'Journal of Obstetrics and Gynecology 2003 189:418–422.
![Vacuum Vacuum](https://workbook.pressbooks.com/wp-content/uploads/sites/50414/2016/05/decidua-capsularis.png)
Background | |
Abortion type | Surgical |
First use | Late 19th century |
Gestation | 4-12 weeks |
Usage | |
WHO recommends only when manual vacuum aspiration is unavailable | |
United States | 1.7% (2003) |
Medical notes | |
Undertaken under heavy sedation or general anesthesia. Risk of perforation. Day-case procedure | |
Infobox references |
Dilation (or dilatation) and curettage (D&C) refers to the dilation (widening/opening) of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping (curettage). It is a therapeutic gynecological procedure as well as the most often used method of first trimester miscarriage or abortion.[1][2][3]
D&C normally refers to a procedure involving a curette, also called sharp curettage.[2] However, some sources use the term D&C to refer more generally to any procedure that involves the processes of dilation and removal of uterine contents, which includes the more common suction curettage procedures of manual and electric vacuum aspiration.[4]
Procedure[edit]
An illustration of a dilation and curettage
The woman is typically put under monitored anesthesia care (MAC) before the procedure begins. The first step in a D&C is to dilate the cervix. This can be done with Hegar dilators. A curette, a metal rod with a handle on one end and a sharp loop on the other, is then inserted into the uterus through the dilated cervix. The curette is used to gently scrape the lining of the uterus and remove the tissue in the uterus. This tissue is examined for completeness (in the case of abortion or miscarriage treatment) or by pathology for abnormalities (in the case of treatment for abnormal bleeding).[2]
Clinical uses[edit]
Manual Vacuum Aspiration Procedure Note
D&Cs are commonly performed for the diagnosis of gynecological conditions leading to 'abnormal uterine bleeding';[5] to resolve abnormal uterine bleeding (too much, too often or too heavy a menstrual flow);[3] to remove the excess uterine lining in women who have conditions such as polycystic ovary syndrome (which cause a prolonged buildup of tissue with no natural period to remove it);[6] to remove tissue in the uterus that may be causing abnormal vaginal bleeding,[2] including postpartum retained placenta;[7] to remove retained tissue (also known as retained POC or retained products of conception) in the case of a missed or incomplete miscarriage (in which some of the tissue remains in the uterus and the cervix stays open. This may increase a woman's risk of infection and continued bleeding);[4] and as a method of abortion.[2] In contrast, D&C remains 'standard care' for missed and incomplete miscarriage in many countries despite the existence of alternatives currently used for abortions.
Because medicinal and non-invasive methods of abortion now exist, and because D&C requires heavy sedation or general anesthesia and has higher risks of complication, the procedure has been declining as a method of abortion.[8] The World Health Organization recommends D&C as a method of surgical abortion only when manual vacuum aspiration is unavailable.[9] Most D&Cs are now carried out for miscarriage management and other indications such as diagnosis.[8][3][6]
Hysteroscopy is a valid alternative to D&C for many surgical indications from diagnosis of uterine pathology to the removal of fibroids and even retained products of conception. It poses less risk because the doctor has a view inside the uterus during surgery, unlike with blind D&C.
Medical management of miscarriage and medical abortion using drugs such as misoprostol and mifepristone are safe, non-invasive and cheaper alternatives to D&C.
Complications[edit]
Complications may arise from either the introduction or spreading of infection, adverse reaction to general anesthesia required during the surgery or from instrumentation itself, if the procedure is performed blindly (without the use of any imaging technique such as ultrasound or hysteroscopy).
One risk of sharp curettage is uterine perforation. Although normally no treatment is required for uterine perforation, a laparoscopy may be done to verify that bleeding has stopped on its own. Infection of the uterus or fallopian tubes is also a possible complication, especially if the woman has an untreated sexually transmitted infection.[2]
Another risk is intrauterine adhesions, or Asherman's syndrome. One study found that in women who had one or two sharp curettage procedures for miscarriage, 14-16% developed some adhesions.[10] Women who underwent three sharp curettage procedures for miscarriage had a 32% risk of developing adhesions.[10] The risk of Asherman's syndrome was found to be 30.9% in women who had D&C following a missed miscarriage,[11] and 25% in those who had a D&C 1–4 weeks postpartum.[12][13][14] Untreated Asherman's syndrome, especially if severe, also increases the risk of complications in future pregnancies, such as ectopic pregnancy, miscarriage, and abnormal placentation (e.g.placenta previa and placenta accreta). According to recent case reports, use of vacuum aspiration can also lead to intrauterine adhesions.[15] A systematic review in 2013 came to the conclusion that recurrent miscarriage and D&C are the main risk factors for intrauterine adhesions.[16] However, that review also found no studies reporting a link between intrauterine adhesions and long-term reproductive outcome, and that similar pregnancy outcomes were reported subsequent to surgical management (including D&C), medical management or conservative management (that is, watchful waiting).[16]
See also[edit]
References[edit]
Manual Vacuum Aspiration Steps For Sale
- ^Pazol, Karen. 'Ph.D'. Center for Disease control. Center for Disease Control. Retrieved 14 January 2014.
- ^ abcdef'Dilation and sharp curettage (D&C) for abortion'. Women's Health. WebMD. 2004-10-07. Retrieved 2007-04-29.
- ^ abcHayden, Merrill (2006-02-22). 'Dilation and curettage (D&C) for dysfunctional uterine bleeding'. Healthwise. WebMD. Archived from the original on 2007-10-21. Retrieved 2007-04-29.Nissl, Jan (2005-01-18). 'Dilation and curettage (D&C) for bleeding during menopause'. Healthwise. WebMD. Retrieved 2007-04-29.
- ^ ab'What Every Pregnant Woman Needs to Know About Pregnancy Loss and Neonatal Death'. The Unofficial Guide to Having a Baby. WebMD. 2004-10-07. Archived from the original on 28 May 2008. Retrieved 2007-04-29.
- ^Anastasiadis PG, Koutlaki NG, Skaphida PG, Galazios GC, Tsikouras PN, Liberis VA (2000). 'Endometrial polyps: prevalence, detection, and malignant potential in women with abnormal uterine bleeding'. Eur J Gynaecol Oncol. 21 (2): 180–183. PMID10843481.
- ^ ab'Dilation and Curettage (D&C)'. www.phyllisgeemd.com. Practice Builders & Health Central Women's Care, PA. 2016. Retrieved 2018-10-17.
- ^Wolman I, Altman E, Fait G, Har-Toov J, Gull I, Amster R, Jaffa A (2009). 'Evacuating retained products of conception in the setting of an ultrasound unit'. Fertil. Steril. 91 (4 Suppl): 1586–88. doi:10.1016/j.fertnstert.2008.10.032. PMID19064261.
- ^ ab'Minor surgical procedure common in O&G associated with increased risk of preterm delivery'. EurekAlert!. European Society of Human Reproduction and Embryology. 16 June 2015. Retrieved 2018-10-17.
- ^World Health Organization, UNICEF, United Nations Population Fund (2017). Managing complications in pregnancy and childbirth: a guide for midwives and doctors. pp. P-71. ISBN9789241565493.CS1 maint: uses authors parameter (link)
- ^ abFriedler S, Margalioth EJ, Kafka I, Yaffe H (1993). 'Incidence of post-abortion intra-uterine adhesions evaluated by hysteroscopy--a prospective study'. Hum. Reprod. 8 (3): 442–4. doi:10.1093/oxfordjournals.humrep.a138068. PMID8473464.
- ^Schenker JG, Margalioth EJ (1982). 'Intra-uterine adhesions: an updated appraisal'. Fertility and Sterility. 37 (5): 593–610. doi:10.1016/S0015-0282(16)46268-0. PMID6281085.
- ^Kodaman PH, Arici A (2007). 'Intrauterine adhesions and fertility outcome:how to optimize success?'. Current Opinion in Obstetrics and Gynecology. 19 (3): 207–214. doi:10.1097/GCO.0b013e32814a6473. PMID17495635.
- ^Rochet Y, Dargent D, Bremond A, Priou G, Rudigoz RC (1979). 'The obstetrical outcome of women with surgically treated uterine synechiae (in French)'. J Gynecol Obstet Biol Reprod. 8 (8): 723–726. PMID553931.
- ^Buttram VC, Turati G (1977). 'Uterine synechiae: variations in severity and some conditions which may be conducive to severe adhesions'. Int. J. Fertil. 22 (2): 98–103. PMID20418.
- ^Dalton VK, Saunders NA, Harris LH, Williams JA, Lebovic DI (2006). 'Intrauterine adhesions after manual vacuum aspiration for early pregnancy failure'. Fertil. Steril. 85 (6): 1823.e1–3. doi:10.1016/j.fertnstert.2005.11.065. PMID16674955.
- ^ abHooker AB, Lemmers M, Thurkow AL, Heymans MW, Opmeer BC, Brölmann HA, Mol BW, Huirne JA (2013). 'Systematic review and meta-analysis of intrauterine adhesions after miscarriage: Prevalence, risk factors and long-term reproductive outcome'(PDF). Human Reproduction Update. 20 (2): 262–78. doi:10.1093/humupd/dmt045. PMID24082042.
External links[edit]
Retrieved from 'https://en.wikipedia.org/w/index.php?title=Dilation_and_curettage&oldid=916342862'