Surgical Abortion Specialist

1^st Trimester Procedures

Vacuum Aspiration or Dilation Suction

This procedure is performed at 5-14 weeks. It is a safe and simple procedure when performed by a Board Certified Gynecologist, and Trained Medical Staff, using a sterile technique, and ultrasound guidance. We will perform an internal exam to determine the position of the uterus, and an ultrasound will monitor the procedure until the tissue is removed. The procedure takes about 4 to 8 minutes. It is the most common type of procedure performed and poses the least risk of complications.

Miscarriage D&C

D&C Procedures are performed in the office with anesthesia, and under ultrasound guidance to diagnosis or treat abnormal uterine bleeding, bleeding after menopause, growths in the uterus, polyps, fibroids, or cancer of the uterus. D&C is the correct procedure to remove excess tissue left behind by an incomplete miscarriage or an incomplete abortion. The tissue samples are sent to the laboratory and results usually are reported to the patient within seven days. The procedure takes about 15 minutes.

Patients should have a driver for the procedure. Once finished, the patient is taken to the recovery area where vital signs and bleeding status is monitored every 15 minutes by a recovery room nurse. After one hour, if the patient is alert, the patient is discharged with instructions and medication. Before leaving, the patient schedules a follow-up appointment.

Complications

A first-trimester abortion is one of the safest procedures and approximately 9-10 times safer than normal childbirth. Complications are rare but they may occur. These risks are easily treated while under the direction of Board Certified Gynecologist, and experienced nursing staff.

Risks include:

• Infection (less than 1%)
• Incomplete abortion (less than 1%)
• Heavy Bleeding (1/2 of 1%)
• Cervical Tear (1/2 of 1%)
• Death (1 in 160,000)

2^nd Trimester Procedures

Vacuum Aspirations performed over 13 weeks – 24 weeks must be performed in facilities licensed and approved by Florida Agency Department of Health.

An Early 2nd Trimester D&E 13-16 weeks is very similar to the First Trimester Vacuum Procedure. However, because the pregnancy is more advanced, the doctor needs to dilate the cervix more to make it possible to remove the tissue. The majority of this tissue must be removed manually, although vacuum aspiration or suction may also be used. Because the walls of the uterus are softer at this stage of pregnancy, this must be done very slowly and carefully to prevent perforation of the uterus.

The latter second trimester of pregnancy (17-24 weeks) requires that the women be in the clinic several hours on two consecutive days. On the first day, after the examination and ultrasound, the physician inserts a few sterile fibers (Laminaria/Dilapan) into the cervix which absorbs moisture from the woman’s body. Overnight, they expand and enlarge the opening in the cervix to facilitate dilation. On the second day, the woman returns to the clinic and the procedure is completed under anesthesia and ultrasound guidance. Using small forceps and gentle suction, the doctor empties the uterus.

After the procedure is completed, you are brought into the recovery room where you will awaken shortly thereafter. A nurse will be with you at all the times and will periodically check your blood pressure, pulse, and bleeding. It is common to feel disoriented, have trouble focusing your eyes, and feel some nausea when you first wake up, but most symptoms will disappear before you leave the facility. Patients will be given some nourishment when you are more alert. Patients must have someone to drive them home after the procedure as they may be groggy from the anesthesia. Medications, aftercare instructions and directions including the date and time for your follow-up will also be given during discharge from the recovery room. A nurse is on call at all times to answer any questions. 24/7 Emergency Hotline: (305) 670-9797

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