Early Options: Vacuum Aspiration as a Backup for Medical Abortion

Early Options - A Provider's Guide to Medical Abortion

After reading this page, you should be able to answer the following question:
Which symptoms would necessitate immediate surgical intervention?

In most cases where vacuum aspiration is necessary as a backup for medical abortion, it can be provided in an office setting using either electric or manual suction.

Clinical reports published to date universally support the role of manual vacuum aspiration (MVA) in completing spontaneous abortion.^47-48 Following an attempted early medical abortion, surgical evacuation typically requires minimal or no cervical dilation since the cervix has already been "ripened" with pharmaceutical agents.

While providers of medical abortion need to have plans in place for providing emergency suction curettage for patients when needed, most surgical completions of medical abortion are not emergencies. Click here to view Figure 5.

In the rare instance of severe hemorrhage, clearly surgical intervention is emergent. In contrast, suction curettage in the case of patient request, or to treat continuing pregnancy, persistent gestational sac, incomplete abortion without hemorrhage, and subjective symptoms unresponsive to medical treatment, is nonemergent and generally can be scheduled and handled during office hours.

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