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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Abortion - surgical

Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical

Last reviewed: November 8, 2012.

Surgical abortion is a procedure that ends a pregnancy by removing the fetus and placenta from the mother's womb (uterus).

Surgical abortion is not the same as miscarriage. Miscarriage is when a pregnancy ends on its own before the 20th week.

Description

Surgical abortion uses a vacuum to remove the fetus and related pregnancy material from the uterus. The procedure is most often done 6 weeks after the woman's last menstrual period or soon afterward when possible.

Before the procedure, you may have the following tests:

  • A urine test checks if you are pregnant.
  • A blood test checks your blood type. Based on the test result, you may need a special shot to prevent problems if you get pregnant in the future. The shot is called Rhogam.
  • An ultrasound test checks how many weeks you are pregnant.

During the procedure:

  • You lie on an exam table.
  • You may receive medicine (sedative) to help you relax and feel sleepy.
  • Your feet will rest in supports called stirrups. These allow your legs to be positioned so that the doctor can view the vagina and cervix.
  • The doctor may numb the cervix so you feel little pain during the procedure.
  • Small rods called dilators will be put in the cervix to gently stretch it open. Sometimes laminaria, or sticks of seaweed for medical use, are placed in the cervix. This is done the day before the procedure to help the cervix dilate slowly.
  • The doctor inserts a tube into the womb and the vacuum is used to remove the pregnancy tissues.

After the procedure, you may be given medicine to help the uterus contract. This reduces bleeding.

Why the Procedure Is Performed

Reasons a surgical abortion might be considered include:

  • Your baby has a birth defect or genetic problem.
  • Your pregnancy is harmful to your health (therapeutic abortion).
  • The pregnancy resulted after a traumatic event such as rape or incest.

The decision to end a pregnancy is very personal. To help you weigh your choices, discuss your feelings with a counselor or health care provider. A family member or friend can also be of help.

Risks

Risks of surgical abortion include:

After the Procedure

You will stay in a recovery area for a few hours. The health care providers will tell you when you can go home. Because you may still be drowsy from the medicines, arrange ahead of time to have someone pick you up. 

Follow instructions for how to care for yourself at home. Make any follow-up appointments.

Outlook (Prognosis)

Complications (problems) rarely occur after this procedure.

Physical recovery usually occurs within a few days, depending on the stage of the pregnancyVaginal bleeding can last for a week to 10 days. Cramping usually lasts for a day or two.

You can get pregnant before your next period, which occurs 4-6 weeks after the procedure. Be sure to make arrangements to prevent pregnancy, especially during the first month after the procedure. You may want to talk with your health care provider about emergency contraception.

References

  1. Annas GJ, Elias S. Legal and ethical issues in obstetric practice. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 54.
  2. Jensen JT, Mischell Jr DR. Family planning: contraception, sterilization, and pregnancy termination. In: Katz VL, Lentz GM, Lobo RA, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 13.

Review Date: 11/8/2012.

Reviewed by: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

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What works?

  • Antibiotic prophylaxis for first trimester induced abortionAntibiotic prophylaxis for first trimester induced abortion
    Infection of the upper genital tract, including the uterus and fallopian tubes, can cause complications after induced abortion. Antibiotics given around the time of the abortion (prophylaxis) could prevent this complication. We found 19 randomised controlled trials that looked at the effect of antibiotic prophylaxis on post‐abortal upper genital tract infection amongst women requesting induced abortion in the first trimester of pregnancy. We looked at the effect of any antibiotic prophylaxis regimen on the outcome. Overall, the risk of post‐abortal upper genital tract infection in women receiving antibiotics was 59% that of women who received placebo. There were, however, differences between the trial results over and above what would be expected by chance alone. It should be noted that, if the infection is caused by a sexually transmitted organism, antibiotic prophylaxis will not protect the woman from becoming re‐infected if her sexual partner has not been treated. None of the trials was done in lower or middle income countries, which is where the risk of post‐abortal complications is highest. Further trials are needed to determine whether combinations of antibiotics can prevent more infections than single antibiotics, or whether antibiotic prophylaxis should be restricted to women with positive results of screening tests before the abortion.
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