Division of Reproductive Health

Post Abortion Care

DRH/MOH

Division of Reproductive Health

 Learning Objectives

• By the end of this session the participant should be

able to:
• Define post abortion care

• Discuss the indications for MVA

• Explain the MVA procedure

Division of Reproductive Health

 Post abortion care (PAC)

• Complications from unsafe abortions account for

around 13 % of maternal deaths worldwide
• PAC is needed to manage complications arising from
unsafe abortion and incomplete spontaneous
miscarriage.
• Haemorrhage
• Sepsis
• PAC is an opportunity to prevent further unplanned
pregnancy by promoting contraceptive use

Division of Reproductive Health

Differential diagnosis of first trimester bleeding

• Rule out ectopic pregnancy!

• Complications from
• Spontaneous miscarriage
• Unsafe abortion
• Molar pregnancy
• Cervical Lesions

Division of Reproductive Health

Post abortion care – Essential elements
• Counselling

• Treatment

• Contraceptive and family planning services

• Reproductive and other health services

• Community service and provider partnerships

• Infection prevention

Division of Reproductive Health

 Approach to diagnosis

History Abdominal Pelvic

Examination Examination

Incomplete Missed Uterus may Bleeding +

miscarriage/ period be palpable Cervical
abortion Pregnancy dilatation +,
symptoms Products
+/- visible +/-,
LAP + Uterus bulky

Division of Reproductive Health

 MANUAL VACCUUM ASPIRATION
• Indications
 Uterine size equivalent to or equal to 12 weeks
 Dilated cervix
• Side effects
 Abdominal cramps
 Occasional nausea
• Advantages
 Cost effective
 Reduced risk of perforation
 Can be performed by non physicians if trained

Division of Reproductive Health

 MVA Procedure

Division of Reproductive Health

 Post procedure
• Counselling (including HIV testing)

• Analgesics, antibiotics

• Contraceptive advice

• Write up notes / equipment processing

• Link/ Referral to other RH services

• Follow up

Division of Reproductive Health

 Thank you

Division of Reproductive Health