POSTABORTION CARE (MANUAL VACUUM ASPIRATION

INITIAL ASSESSMENT
1. Greets woman respectfully and with kindness.
2. Assesses patient for shock or complications.
MEDICAL EVALUATION
1. Takes a reproductive history and perform physical
examination and laboratory tests.
2. Gives her information about her condition.
3. Discusses her reproductive goals.
GETTING READY
1. Tells the woman (and her support person) what is going
to be done, listen to her and respond attentively to her
questions and concerns.
2. Provides continual emotional support and reassurance, as feasible.
3. Asks about allergies to antiseptics and anesthetics..
4. Gives pethedine 100mg and Diazepam 10mg or
Diclophenac 50(75) mg as appropriate to the woman
before the procedure.
5. Determines that required sterile or high-level disinfected
instruments and cannula are present.
6. Checks that patient has recently emptied her bladder and
washed her perineal area.
7. Puts on personal protective barriers.
8. Washes hands thoroughly and puts on high-level
disinfected or sterile surgical gloves.

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9. Arranges sterile or high-level disinfected instruments on
sterile tray or in high-level disinfected container.
10. Checks MVA syringe and charges it (establish vacuum).
Ensure that appropriate size cannula and adapters are
available.
PREPROCEDURE TASKS
1. Gives Oxytoxin and/or antibiotics IV if there is an indication.
2. Cleans the genitalia and drapes the woman
3. Performs bimanual examination.
4. Inserts speculum.
5. Applies antiseptic to cervix and vagina two times.
6. Removes any products of conception (POC) and
checks for any cervical tears.
MVA PROCEDURE
1. Explains each step of the procedure prior to performing it.
2. Puts single-toothed tenaculum or vulsellum forceps on
anterior lip of cervix.
3. Administers paracervical block (if necessary).
4. Applies traction on cervix.
5. Dilates the cervix (if needed).
6. Inserts the cannula gently through the cervix into the uterine cavity.
7. Attaches the prepared syringe to the cannula.
8. Evacuates contents of the uterus.
9. When signs of completion are present, withdraws
cannula and MVA syringe. Empties contents of MVA
syringe into a strainer.

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10. Removes forceps or tenaculum and speculum.
11. Performs bimanual examination.
12. If uterus is still soft or bleeding persists, repeats steps 5–10

13. Inspects tissue removed from uterus to ensure complete evacuation

POST-PROCEDURE TASKS
1. Before removing gloves, disposes of waste materials in a
leakproof container or plastic bag.
2. Flushes MVA syringe and cannula with 0.5% chlorine
solution. And disposes needle and syringe in a puncture
proof container or safety box
3. Decontaminates gloves in 0.5% chlorine solution and
disposes in leakproof container
4. Washes hands thoroughly.
5. Checks for bleeding and ensure cramping has
decreased before discharge.
6. Instructs patient regarding post abortion care.
7. Discusses reproductive goals and, as appropriate,
provides family planning.

By Gebremichael Reta BSc.