August 23rd, 2019

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Uterine Evacuation via Vacuum Aspiration With and Without Sharp Curettage: A Pilot Study
Authors:  Lisa Hofler, M.D., MPH, Anna Merport Modest, MPH, Laura E. Dodge, Sc.D., MPH, Michele R. Hacker, Sc.D., MSPH, and Sadia Haider, M.D., MPH
  OBJECTIVE: To evaluate whether adjunctive sharp curettage affects procedure length, blood loss, perceived pain, or patient satisfaction among women undergoing surgical uterine evacuation under sedation in the operating room.

STUDY DESIGN: We prospectively enrolled a convenience sample of women who chose outpatient surgical management of missed abortion, induced abortion, or retained products of conception. Immediately prior to discharge, women completed a self-administered survey addressing pregnancy history and satisfaction with the procedure. Procedure-related data, including length of procedure, estimated blood loss, and use of sharp curettage, were collected from the medical record.

RESULTS: Twenty-four women underwent vacuum aspiration followed by sharp curettage, and 66 underwent vacuum aspiration alone. This study did not detect any benefit from adjunctive sharp curettage for uterine evacuation. Providers with extensive family planning experience did not use sharp curettage in any of the 35 procedures they performed.

CONCLUSION: Providers who perform relatively few uterine evacuations may be more likely to rely on adjunctive sharp curettage. Adequate physician training in vacuum aspiration is therefore important, and physicians must understand the potential risks of additional instrumentation of the uterus with sharp curettage.
Keywords:  curettage, dilatation and curettage, incomplete abortion, induced abortion, missed abortion, sharp curettage, uterine evacuation, vacuum aspiration, vacuum curettage
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