Module III: First-Trimester Uterine Aspiration Abortion and Second-Trimester Dilation and Evacuation
Module Review Information
The resources in this module were reviewed by Deborah Bartz, MD, MPH and Katherine Brown, MD, MAS in Spring 2025.
Learning Objectives
- Understand the principles of uterine aspiration abortion and dilation and evacuation (D&E).
- Describe cervical preparation techniques for uterine aspiration abortion and D&E.
- Safely and effectively manage patients’ pain during first-trimester uterine aspiration abortion and second-trimester D&E.
- Understand techniques to prevent and manage post-abortion complications.
Articles
Shih G, Wallace R. First-trimester Pregnancy Termination: Uterine Aspiration.
https://www.uptodate.com/contents/first-trimester-pregnancy-termination-uterine-aspiration#topicContent
Hammond C. Overview of Second-trimester Pregnancy Termination.
https://www.uptodate.com/contents/overview-of-second-trimester-pregnancy-termination#topicContent
Diedrich JT, Drey EA, Newmann SJ. Society of Family Planning Clinical Recommendations: Cervical Preparation for Dilation and Evacuation at 20-24 Weeks’ Gestation.
Contraception
. 2020;101(5):286-292. doi:
10.1016/j.contraception.2020.01.002
Cansino C, Denny C, Carlisle AS, Stubblefield P. Society of Family Planning Clinical Recommendations: Pain Control in Surgical Abortion Part 2 – Moderate Sedation, Deep Sedation, and General Anesthesia.
Contraception
. 2021;104(6):583-592. doi:
10.1016/j.contraception.2021.08.007
Henkel A, Blumenthal PD. Second-trimester Abortion Care for those with Complex Medical Conditions.
Curr Opin Obstet Gynecol
. 2022;34(6):359-366. doi:
10.1097/GCO.0000000000000817
Uterine Aspiration Videos
Innovating Education in Reproductive Health. Uterine Aspiration Videos. Vimeo. https://vimeo.com/album/3395660. Accessed April 2025.Includes animations of paracervical block, MVA use. Password: outpatientEPL2015
Trending Topics
Bayat L, Biefeld S, Sussman AL, Hofler L, Pereda B, Espey E. Defying the odds: Facilitating integration of abortion care into clinical practice in the United States.
Contraception
. 2024;138:110510. doi:
10.1016/j.contraception.2024.110510
Liu SM, Henkel A, Meza P, et al. Comparing transcervical balloon with osmotic dilators for cervical preparation prior to procedural abortion: A noninferiority randomized trial.
Contraception
. 2024;140:110550. doi:
10.1016/j.contraception.2024.110550
Supplemental Resources
Lee SJ, Ralston HJP, Drey EA, Partridge JC, Rosen MA. Fetal Pain: A Systematic Multidisciplinary Review of the Evidence.
JAMA
. 2005;294(8):947-954. doi:
10.1001/jama.294.8.947
O’Shea LE, Lord J, Fletcher J, Hasler E, Cameron S. Cervical priming Before Surgical Abortion up to 13+6 Weeks’ Gestation: A Systematic Review and Meta-analyses for the National Institute for Health and Care Excellence-New Clinical Guidelines for England.
Am J Obstet Gynecol MFM
. 2020;2(4):100220. doi:
10.1016/j.ajogmf.2020.100220
O’Shea LE, Lohr PA, Lord J, Hasler E, Cameron S. Cervical Priming Before Surgical Abortion Between 14 and 24 Weeks: A Systematic Review and Meta-analyses for the National Institute for Health and Care Excellence-New Clinical Guidelines for England.
Am J Obstet Gynecol MFM
. 2021;3(1):100283. doi:
10.1016/j.ajogmf.2020.100283