Suction dilation and curettage

a. Analgesia consists of meperidine (Demerol), 35-50 mg IV over 3-5 minutes until the patient is drowsy.

b. The patient is placed in the dorsal lithotomy position in stirrups, prepared, draped, and sedated.

c. A weighted speculum is placed intravaginally, the vagina and cervix are cleansed, and a paracervical block is placed.

d. Bimanual examination confirms uterine position and size, and uterine sounding confirms the direction of the endocervical canal.

e. Mechanical dilatation is completed with dilators if necessary. Curettage is performed with an 8 mm suction curette, with a single-tooth tenaculum on the anterior lip of the cervix.

4. Post-curettage. After curettage, a blood count is ordered. If the vital signs are stable for several hours, the patient is discharged with instructions to avoid coitus, douching, or the use of tampons for 2 weeks. Ferrous sulfate and ibuprofen are prescribed for pain.

5. Rh-negative, unsensitized patients are given IM RhoGAM.

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