Surgical evacuation of suspected retained products of conception

Surgical evacuation is a first-line option for management of suspected retained products of conception if the individual:

• has haemorrhage; consider the need for emergency management
• has significant retained products of conception confirmed on ultrasound combined with any of:
  • moderate to heavy bleeding
  • mild anaemia
  • concurrent infection
• has heavy ongoing bleeding even if retained products are not visible on ultrasound
• has moderate to severe anaemia; refer for urgent ultrasound to establish extent of retained products and arrange a gynaecological consultation
• prefers surgery to expectant or medical management.

Surgical evacuation can also be considered if bleeding persists after expectant or medical management.

Surgical evacuation is required in 3 to 5% of individuals who undergo medical abortion.