Table 2 Audit Criteria for acceptable management

1. Assessment of vital signs^a:

 Measure blood pressure, pulse, temperature^b and respiration frequency.

2. Fluid resuscitation:

 At a systolic blood pressure ≤ 90 mmHg: infuse two litres of fast running normal saline.

3. Broad-spectrum antibiotics:

 Give antibiotics at: temperature ≤ 36° or ≥ 38° Celsius, purulent foul smelling vaginal discharge, surgical evacuation or unsafe abortion.

4. Evacuation of retained intrauterine products:

 Medical evacuation: misoprostol. Surgical evacuation: manual vacuum aspiration or blunt curettage.

 For gestational age ≤ 12 weeks surgical evacuation shall be performed with manual vacuum aspiration.

 Expectant management is only recommended when the well-informed patient wish to use this method and no additional complications are present.

5. Pain management:

 Any expression of pain shall result in analgesics to the patient.

6. Waiting time for evacuation at sepsis or heavy bleeding:

 Acute emergency evacuation of the uterus must be performed. This shall not be delayed by expectant antibiotic treatment but performed immediately.