Chapter 32 Uterine Aspiration
Equipment
The instruments needed for the procedure are a tenaculum, a uterine sound, a set of cervical dilators, a flexible plastic suction curette attached to a suction device, and a sharp curette (Figure 32-1). To perform the paracervical block, refer to Chapter 31.
Key steps
1. Preparation: Place the patient in the lithotomy position. Cleanse the perineum, vulva, vagina, and cervix with an antiseptic solution. Drape the perineum, leaving access to the vagina and cervix for the procedure. Determine the position of the patient’s uterus by performing a bimanual examination. Insert a weighted speculum or a bivalve speculum, depending on the patient’s anatomy (Figure 32-2). The cervix must be clearly visible to perform the procedure.
2. Sounding the uterus: When adequate anesthesia is obtained, grasp the anterior cervix horizontally with a tenaculum. Insert the uterine sound into the os, and apply gentle pressure until the internal os dilates and the sound enters the uterine cavity. Note the measurement of the internal uterine length by identifying the insertion depth from the external os on the sound. Use this depth as the maximum insertion length of any instrument during the procedure (Figure 32-3).
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