Cleaning and disinfection is enough. A common speculum and two swab forcepses is enough. The vaginal toilet is described in Chapter 9. The single blade speculum gives much more freedom for the instruments. A disadvantage is that it may drop out of the vagina and that an assistant is necessary to hold the tenaculum forceps.
Dilation is done with a number of dilators.
Dilation with a tapering dilator is much less traumatising. But if the pregnancy is very young there is a danger of perforating the fundus if the dilator is brought in too deep. After dilation the uterus is evacuated with a disposable plastic suction curette. A slender forceps is necessary to remove tissue which is fixed in the canula or trapped in the cervical canal. The Karman canula is made from hard nylon.