ERPC

Question 1

What is the principle of an evac?

Answer 1

Prostaglandin PV prior to procedure (reduce risk uterine/cervical trauma)
Once anaesthatised, grasp cervix and dilate 1-2cm
Rigid/flexible curette in appropriate size used to remove products of conception under suction
USS guidance may be used

Question 2

What are the indications for evac?

Answer 2

Retained products of conception (from miscarriage, remnants of placenta postpartum, gestational trophoblastic disease, ToP, previous incomplete SMM)

Question 3

What can be done at the same time as an evac?

Answer 3

Contraception inserted

Question 4

What are the risks associated with evac?

Answer 4

Big four
Uterine perforation
Retained products remaining
Intrauterine adhesions
Cervical tears

Question 5

If evac is performed for miscarriage, what is the cut off and why?

Answer 5

<13w

Higher risk of complications, medical management safer