2-25. UTERINE ASPIRATION (SUCTION CURETTAGE)
a. General. This operation involves the vacuum aspiration of the contents of the
uterus. This has proven to be a safe and effective method for early termination of
pregnancy and for use in missed and incomplete abortions. Advantages include less
dilatation of the cervix, less damage to the uterus, less blood loss, less chance of
uterine perforation, and reduced danger of infection.
b. Patient Preparation. The patient is placed in the lithotomy position under
general anesthetic. An external and internal vaginal prep is done.
c. Operative Procedure.
(1) The cervix is exposed using an Auvard weighted speculum and an
anterior retractor; then the cervix is grasped with a sharp tenaculum and drawn toward
the introitus (see figure 2-6).
Figure 2-6. Uterine aspiration. A-Insertion of the cannula. B-Gentle suction
motion to aspirate contents. C-Uterus evacuated.
(2) The cervix is dilated in the routine manner, allowing 1 mm of cannula
diameter for each week of pregnancy.
(3) The appropriate sized cannula is then inserted into the uterus until the
sac is encountered. The vacuum is turned on with immediate disruption and aspiration
of the contents. Continued gentle motion of the cannula will remove the entire uterine