CHECK LIST FOR MTP CENTER UNDER MTP ACT, 1971

1 Facilities for safe and hygienic place for performing MTP in center approved up to
12 weeks of pregnancy
1.1. Gynecology examination/labor table should be available

1.2.Resuscitation equipments should be available (Ambu bag, Oral airway, Oxygen

cylinder with oxygen)
1.3. Equipments required for MVA/EVA available as per list mentioned below

1.4. Sterilization equipments should be available (Autoclave, Boiler, Cidex tray)

1.5. Essential drugs available as per list enclosed

1.6. Drugs required for treatment of emergencies should be available as per list enclosed

1.7. IV fluids

1.8. Essential supplies should be available as per enclosed list.

1.9. Drugs required for medical method of abortion if available (Mifepristone,

Misoprostol, Analgesics, Antiemetics) should be mentioned
1.10. Facility for transportation available if needed to transfer the pt. to higher center

2 Facilities for safe and hygienic place for performing MTP in center approved up to
20 wks of pregnancy (List prescribed is attached at Annexure)
2.1.Gynecology operation table

2.2. Essential equipment/instruments for performing abdominal/gynecological surgery

should be available (Ovum forceps, Foley’s catheter No.12,14, 16, instruments for
laprotomy, gynecological and abdominal surgery).
2.3. Anesthetic equipments should be available (Boyle’s Apparatus, endotracheal tubes
etc.)
2.4.Resuscitation equipments

2.5. Sterilization equipments

2.6. Drugs required for MTP

2.7. IV fluids
 2.8. Back up facilities for treatment of shock should be available if needed

2.9. Facility for transportation available if needed to transfer the pt. to higher center

3 Doctors performing MTPs/Abortions (Name and Qualification)

Name: Qualification:

Name: Qualification:

3.1. Copy of the qualification certificate of the doctor performing MTP should be
available & to be exhibited at prominent place
3.2. The doctor/s performing MTP should meets qualification requirement as per MTP
Act
3.2.1 Certificates of their qualification should be available

3.3. Valid registration certificate of Maharashtra Medical Council for the doctor/s should
be available
6 If this Center also provide USG services

6.1. If yes, is the center registered under PCNDT Act to be intimated to PCMC-Medical
Dept. by a separate letter.

If Center to practice Medical Methods of Abortion (Medical Abortions) then keep the
following information with the center at all the time
1. Details of RMP/General Medical Practitioners prescribing drugs like mifepristone
(RU486) and misoprostol at their clinic and referring such cases for MTP or complications to
this MTP center.
1.1. If RMP/General medical practitioners who are prescribing the medical abortion drugs
and referring such cases for medical abortion in this center then the list of names to be
displayed at the center.
1.2. Also mention such RMP/General medical practitioners are qualified as per Rule 5 of
MTP Rules 2003
 ANNEXURE
The List of Essential Equipments/ Instruments for performing MVA, EVA or Both
procedures:

Sr. No. Name of Equipment/Instrument

1 Sim’s and/ or Cusco’s speculum
2 Anterior vaginal wall retractor
3 Allis forceps or vlsellum (small toothed)
4 Sponge holding forceps
5 Blunt and sharp curette
6 Cheatle’s forceps
7 Bowel for antiseptic solution
8 Proper light source/Torch
9 MVA aspirator and /or Electric Suction machine
10 Cannulae of required sizes
11 Kidney tray
12 Strainer for tissues
Plastic bucket for chlorine solution for keeping soiled
13
instruments
List of Essential Drugs:
Sr. No. Name of Essential Drugs
1 Antibiotics: Ampicilline, Amoxicilline, Cephalexin or a
suitable alternative
2 Analgesic: Paracetamol, Pentazocin, Dicyclomine or a
suitable alternative
3 Injection Atropine sulphate
4 Local Anaesthetic: Inj. Lignocaine 1-2%
5 Injection Diazepam
6 Uterotenics: Inj. Oxytocine, methylergometrine, Inj.
Prostaglandins and/or tablet mesoprostol
7 Dextrose 5% and Ringer lactate, IV set, Canulae or scalp
vein sets

List of Drugs for Treatment of Emergencies:

Sr. No. Name of Emergency Drugs
1 Injection Adrenaline
2 Injection Aminophyline
3 Injection Sodiumbicarbonate 7.5%
4 Injection Calcium Gluconate 10%
5 Inj. Metchlopramide (suitable antiemetic).
5 Inj. Promethasine (suitable antihistaminic)
6 Inj. Hydrocortisone (steroid)
 List of Essential Supplies:
Sr. No. Name of Essential Supplies
1 Antiseptic solution: Providon iodine solution
2 Sterile cotton swabs
3 Sterile gloves
4 Clean perineal sheet (desirable)
5 Sterile Syringe and needle for administering paracervical block and other
drugs
6 Sterile saline or water for washing before instruments that are chemically
sterilized or high level disinfected before use.
7 Chlorine solution/ bleaching powder

Infrastructure required for Second Trimester Terminations: In addition to all

requirements enlisted above for VA procedures, following are needed for the second
trimester procedure.
Sr. No. Name of Essential Supplies
1 Essential Equipments/Instruments: Ovum Forceps, Foleys
catheters No. 12,14,16. Instruments for laprotomy,
gynaecological and abdominal surgery.
2 Equipments for resuccitation/anaesthesia: Boyle’s apparatus
and Endotracheal tubes.
3 Equipments for sterilization: Same as for VA
procedure.
4 Essential Supplies: Sutures of different sizes
5 Essential Drugs for medical induction: Ethacridine lactate,
Laminarai tents, mesoprostal
6 Drugs for Treatment of Emergencies: Same as for VA
procedures.
 Source: Comprehensive Abortion Care, Training and Service Delivery
Guidelines. Ministry of Health and Family Welfare, Government of India.