(3 to 14 weeks)
The first trimester procedure
includes the necessary laboratory studies, in-depth counseling,
and a preoperative examination with ultrasound performed at the
physicians discretion to determine the length of pregnancy
as precisely as possible. The exam also provides the opportunity
to identify any unusual or pathologic aspects of the pregnancy
or pelvic structures that could affect safety. The ultrasound
screening is included in the patient's fee.
Routine laboratory testing includes
a hematocrit (test for anemia), Rh typing, and a basic urinalysis.
Vital signs (blood pressure, temperature, and pulse) are performed.
These tests are also included in the fee.
Following a counseling session to
provide the information necessary to give informed consent,
the patient will meet with Dr. Pendergraft or one of the other
qualified Physicians on our staff to answer any remaining
questions, review follow-up plans, and determine birth control
methods to be used after the abortion.
The patient then receives a routine physical and pelvic examination
by the physician. The patient is then given General or Intravenous (IV) Sedation to make the patient as comfortable
as possible once the abortion procedure begins. Local anesthesia
is administered to the cervix in order to minimize discomfort.
The suction cannula is then inserted into the cervix and the
uterine contents are removed by vacuum aspiration which is
completed in one to three minutes.
When an expected first trimester pregnancy termination is
found to have advanced to 13-14 weeks, the procedure is performed
under ultrasound guidance to decrease the risk of uterine
perforation. Additional medication is then used with the local
anesthetic to decrease the incidence of bleeding. These steps
assure maximum safety for the patient.
For patients who are found to have
a cervix that is difficult to dilate or will not dilate; the
physician has the option of inserting one or several Laminaria
into the cervix or placing Misoprostol into the posterior
vaginal vault.
Laminaria is a naturally occurring
seaweed about the size of a kitchen matchstick and has the
property of absorbing moisture from the body and slowly becoming
larger. It has been medically prepared so as to prevent infection.
After it has been placed in the cervix, the Laminaria expands
overnight and dilates the cervix in a gentle, natural manner
that reduces pain during the procedure and reduces the risk
of uterine perforation.
Misoprostol is a prostaglandin which, when used in high enough
doses, causes the cervix (opening of the womb) to soften, and
dilate (open), and the uterus to contract. This leads to it
being much easier to dilate the cervix in a gentle, natural
manner that reduces the chance of perforation.
The patient is evaluated in the recovery room for an appropriate
amount of time, and will be observed for evidence of any complications.
The patient is then given a
follow-up exam appointment, unless she wishes to visit her
own physician or another facility for her follow-up care.
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