Post-abortion care (PAC)

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Description

  • PAC is safe when provided by a trained provider in an environment with adequate hygiene and suitable equipment. All institutions offering PAC services should be registered by appropriate regulatory protocols.
  • PAC can be provided from health levels as low as the health post (depending on available skills and clients condition) up to tertiary level. All institutions providing PAC should be guided by local protocols.
  • Emergency preparedness should be available in all facilities providing All facilities should be able to stabilize, treat or refer patients with post-abortion complications.
  • Emergency treatment
  • Assessment should include assessment of vital signs and indication of how clinically stable the patient
  • Any patient discovered with a life-threatening condition such as shock, ectopic pregnancy, sepsis or haemorrhage should have resuscitative measures instituted immediately.
  • Physical examination should include a pelvic examination noting any vaginal discharge, vaginal bleeding, uterine size and presence of retained products of conception (RPOCs). Signs of infection including fever, foul smelling discharge, and tender uterus should also be documented.
  • If an infection is suspected, appropriate laboratory specimens should be taken but should not delay the initiation of treatment.
  • Appropriate laboratory tests such as Hb, blood grouping and cross matching and any other tests indicated by the medical condition of the patient should be done.

For the management of complications, refer to local protocols or the National Standards & Guidelines for Comprehensive Abortion Care in Zambia