title: Best practices in surgical abortion.
abstract: Surgical abortion in the first trimester comprises the majority of voluntary pregnancy interruptions performed in the United States. The majority of these procedures are done in outpatient settings with the patient under local anesthesia. Appropriate volume of and deep injection of local anesthetic can reduce pain associated with the procedure. Waiting between administration of the paracervical block and initiating the procedure does not affect pain. Intravenous administration of sedation and analgesia improves patient satisfaction but does not significantly affect pain ratings. Antibiotic prophylaxis is warranted. Vasopressin is useful for prevention of hematometra and hemorrhage. Less evidence supports the routine use of ergots. Preoperative cervical priming reduces the risk of cervical injury and uterine perforation. Attention to operative technique can reduce the risk of incomplete abortion. Routine postoperative care at 2 or 3 weeks is timed to identify complications and to reinforce pregnancy and sexually transmitted disease prevention.
authors.affiliation: Department of Obstetrics and Gynecology, Ohio State University, Columbus, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Keder
mesh_terms: D000019:Abortifacient Agents / Q000494:pharmacology; D000028:Abortion, Induced / Q000009:adverse effects / Q000592:standards*; D005260:Female; D006801:Humans; D013513:Obstetric Surgical Procedures / Q000592:standards*; D010166:Palliative Care; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D011247:Pregnancy; D011315:Preventive Medicine / Q000379:methods; D011787:Quality of Health Care
chemical_list: D000019:Abortifacient Agents