The document provides guidance on performing manual vacuum aspiration (MVA) for abortion, including preparing the client, administering pain management, performing the procedure, monitoring the client's recovery, providing contraceptive counseling, and following up after the procedure. Instructions are given on using appropriate instruments, maintaining aseptic technique, managing complications, and educating the client on what to expect during the recovery process.

1. MS SUPRIYA CHINCHPURE
Lecturer, SVCON

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5. Double valve syringe
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6. In the old fashion cannulae, the
adaptors were provided separate
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7. Color Coding of cannula:
Yellow=4mm
lightGreen 5mm
Blue=6mm
Brown=7mm
White=8mm
Tan=9mm
DarkGreen =10mm
No12 mm Dark blue
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11. Pain Management during MVA
 Women’s responses to pain vary.
 Goal: reduce pain and anxiety, minimize risk.
 Plan should be based on woman’s individual needs and
preferences.
 Plan should be created by woman and provider.
 Psychological pain: anxiety, fear, apprehension
 Cervical pain due to dilatation.
 Uterine cramping due to manipulation.
Timing:
 Drug must be most effective at the time of the procedure.
 Administer drugs 30 to 45 minutes before the procedure.

12. Non- Pharmacological
 Gentle, respectful
interaction and
communication
 Verbal support and
reassurance
 Gentle, smooth
operative technique
 Can supplement but
not replace
medications
Pharmacological
 Anxiolytics /sedatives
relieve anxiety
(Diazepam).
 Analgesics relieve pain
(Ibuproffein).
 General anesthesia
should be reserved for
extreme cases
(paracervical block
using lidocaine ).

13. Preparation of Client:
 Explains procedure to patient & take written consent
 Provide psychological support & build good IPR
 Confirms patient had medication half an hour before
 Asks the woman to empty her bladder and clean
perineum.
 Assists mother in lithotomy position.

14. ARTICLES
Sr. No. Articles Qty Purpose
1 Sterile tray with lid 1 To save time & energy
2 Kidney tray 1 To collect the products from the MVA syringe
3 Cusco’s Vagi al speculu 1 To visualize the cervix
4 Bowl 1 To collect cotton swabs
5 Vulsellum 1 To hold the lip of cervix while giving anaesthesia
6 Sponge holding forceps 1 To clean the cervix
7 Vaginal drape 1 To maintain sterile environment & prevent infection
8 Sterile gloves 2 To maintain asepsis & prevent infection
9 Cotton swabs To clean the cervix
10 Vaginal pads 1 After procedure there would be bleeding & to assess amount of bleeding
11 Clean Tray 1 To save time & energy
12 MV Aspirators with cannula ( check if
working)
2 To perform the procedure & two sets to replace if any functional problem.
13 Syringe 10 Ml 1 To give local anaesthesia
14 Inj. Xylocain1% It acts as a anaesthetic (paracervical block)
15 Betadine solution It act as disinfectant

15. Preparation of Environment &
Self:
 Privacy should be maintained (screen or closed
room)
 All the articles are arranged near procedure site
 All the ornaments, finger rings, bangles etc are
removed.
 Put on all Universal protective devices
 Wash hands

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20. The size of cannula is roughly
the number of gestational weeks
i.e. 7wks= 7mm cannula
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25. Reuse of the instrument:
 HLD in 0.5%ChlorineSolution
 HLD by Boiling
 HLD inCidex
 Sterilization usingAutoclave
 Sterilization using ETO

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27. Post Procedure:
 Reassure the woman that the procedure is finished.
 Help her into a comfortable position.
 Ensure she is escorted to the recovery area.
 Care provided after uterine evacuation completed
 Any physical complications addressed
 Woman informed about her condition and self-care
 Ends when she is discharged

28. Physical monitoring:
 Ensure that the woman is
resting comfortably.
 Take her vital signs
immediately.
 Review chart for condition,
history.
 Monitor her physiological
status.
 Assess and manage
complications:
 Significant physical decline
 Dizziness, shortness of breath,
fainting
 Severe vaginal bleeding
 Severe abdominal pain,
cramping
 Support her recovery.
 Evaluate bleeding and
cramping twice.
 Evaluate pain level, patterns.
 Offer choices for pain relief:
 Analgesics, NSAIDs
 Administer, monitor pain
medications.
 Offer support, including
compresses and
compassionate touch.
 If a woman’s pain increases,
she needs attention.

29. Post procedure contraceptive counseling
 Women may be able to focus on their contraceptive
needs.
 Women may be motivated to prevent unwanted
pregnancies.
 Discuss the woman’s reproductive plans.
 Ensure she receives counseling and a contraceptive
method or referral.
 Remember that some women may desire another
pregnancy.

30. Normal recovery:
 A few days of menstrual-like bleeding, cramping
 Analgesics, baths, compresses for cramping
 Next menses: four to eight weeks
 Can get pregnant almost immediately
 Intercourse, tampons when any complications
resolved
 Provide Instructions for medications

31. Alarming Signs:
 Fever, chills, fainting, vomiting
 Swollen, tender abdomen
 Foul discharge
 Cramping, bleeding more than normal menses
 Delay in resumption of menstruation (more than
eight weeks)

32. The Follow Up Visit:
 Scheduled before discharge from facility.
 Timing varies; usually scheduled within one week.
 May not be at same facility.
 Woman may be referred to provider in her
community.

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