Renal and hepatic disease (affecting drug metabolism, clearance, contraception)
Allergy to latex, iodine, shellfish and medications
Assist client with a contraceptive plan; complete informed consent before sedation given
Perform a focused physical exam:
Vital signs, height and weight (BMI)
Mallampati score (required in some settings prior to moderate sedation)
Cardiac, pulmonary, and / or abdominal exam as indicated by history
If elevated, confirm BP with appropriate sized cuff after sitting quietly; may warrant pre-procedure treatment (i.e. >160/110) or referral
Tachycardia or arrhythmia: consider anxiety, stimulants, etc. If significant and previously undiagnosed, may warrant delay for evaluation
Obesity (may be associated with greater procedural difficulty).
Perform pelvic exam prior to the procedure:
Bimanual for uterine size, position, fibroids, anomalies, pain
Speculum exam for cervicitis or vaginitis warranting testing / treatment
Chlamydia (CT) / Gonorrhea (GC):
For asymptomatic clients, refer to CDC STD Guidelines: annual screening for women <25-years-old; others if increased risk (i.e. new or multiple partner, etc).
If cervicitis is present on exam, test for GC / CT and begin presumptive treatment at least one hour prior to aspiration. Note: Untreated CT / GC increases risk of postabortal endometritis, with associated sequelae.
Even in asymptomatic clients, pre-procedural antibiotic prophylaxis for uterine aspiration is well supported by the available evidence (Low 2012; Achilles 2011).