Preventing infection after uterine aspiration is an important goal. Measures to accomplish this include properly sterilizing instruments, administering prophylactic antibiotics as indicated, minimizing bacterial entry into the sterile uterine cavity, and meticulously using the “no touch” technique to assure that the portions of instruments entering the uterine cavity remain sterile (Paul 2009). The provider:
- Maintains sterility of the surgical tray: non-sterile instruments should be separately available, and contaminated instruments should be placed separately on tray.
- Avoids contamination by gathering needed materials before placing speculum.
- Holds only the center of dilators, not the tips that will enter the uterus.
- Attaches the sterile cannula to the vacuum source without touching the cannula tip.
- Avoids vaginal contamination of uterine instruments.
- Change instruments that will enter the uterus if inadvertently contaminated.
Even with antiseptic cleansing, it is impossible to “sterilize” the vagina. In fact, randomized studies showed that preoperative antiseptic vaginal cleansing had no effect on post-abortal infection rates (Varli 2005, Lundh 1983). Even using sterile gloves, sterility is compromised when touching the client’s perineum and vagina to insert the speculum. Some providers routinely use non-sterile gloves for uterine aspiration, which is acceptable if the no-touch technique is scrupulously maintained