This protocoltooltip textprint-ready/PDF version of the protocol is also available.
Patients requesting appointments for abortion should be scheduled as soon as possible but preferably no later than 7 days after appointment request.
This protocol is designed for those wanting to provide MVA in an outpatient setting such as a family medicine office. You may want to consider an alternative location or special preparations if:
A clinician who is credentialed to perform MVA must be present during the procedure.
In addition to the clinician performing the MVA, an additional person, such as a medical support person (LPN, PCT, MA, etc.) must be available in the room during the procedure. A patient support person may be present but does not replace the need for a medical support person.
The medical support person can have the role(s) of:
A learner (resident, student, or other learner) may be in the room and/or involved in the procedure only after the patient agrees to their participation. Recommended roles for learners include:
An instrument cart can serve for storage of instruments as well as a stable, sterile surface for instruments during the procedure. The cart must remain locked when not in use.
Preventing infection is an important goal during a uterine aspiration. During the procedure, the provider and staff will use a no-touch technique
Sterile drape for tray
Syringes (10cc x 2) and Needle (21 or 22 gauge, 1.5 inch)
Sterile cannulas (plastic, flexible and/or rigid) up to 12 weeks size
Sterile gauze 4×4
GC/CT, pap if needed
Sealed specimen cup with formalin
Kidney basin (disposable or metal)
Sterile metal specula in multiple sizes
Serrated ring forceps
Sterile Pratt dilators
Several lubricated MVA syringes (put together and tested before each use)
Strainer and glass dish
Light box such as artist’s tracing box
Local anesthetic such as lidocaine 1% or bupivacaine 0.25%, or equivalent items available in your facility
Antibiotic prophylaxis; often doxycycline, azithromycin, or metronidazole
Consult with your institution to determine whether a “time out” is required by Joint Commission regulations prior to the procedure. Obtaining the consent in the presence of the involved staff may serve as an appropriate substitute. Otherwise, “time out” may include verifying the patient’s name and DOB prior to the procedure.
Even if sending to pathology, inspection of POCs is integral to the procedure. Determine who will be evaluating the POCs and where this will be done.
Allow patient to see POCs upon request.
All institutions have different policies and procedures for sterilization of instruments. A trained staff member will soak used instruments in enzymatic cleaner, scrub any soiled areas, and then rinse the instruments, and let them air-dry. All used medical instruments must be kept in a “used instruments” area of a room. Once dry, the instruments need to autoclaved on-site or sent out for autoclaving.
Autoclaving on-site:• Document training and certification in sterilization/infection control procedures.• Maintain a log for machine runs, cleaning schedule, weekly spore test/biologic indicator results.
Sterile instruments may be kept in the instrument cart.