Title: Manual Vacuum Aspiration – A Safe Tool in the Surgical Management of Early Weeks Incomplete Abortion

Authors: Prof. Dr Latha.K, Dr Jayashree.V, Dr Mahalakshmi. S

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i10.61

Abstract

The aim of the study was to evaluate and analyze the efficacy of MVA in the process of evacuation of the left out products in incomplete abortion in the first trimester. The study was also employed to evaluate the advantages of the procedure, the chance and the rate of occurrence of complications which usually occur with the other surgical methods in first trimester abortion1

Materials and Methods: The study included 80 patients with history of incomplete abortion of any cause in the first trimester (<12 weeks) with patent cervix, no associated pelvic pathology and endometrial thickness of >15mm. the study was done in the Department of Obstetrics and Gynaecology, in RMMCH, Chidambaram, Tamilnadu from January 2017- June 2018 for 18 months. This is an empirical study done to analyze the efficacy and advantages of the procedure.

Result: Around 97.5% of patients had complete evacuation of the conceptus and only 2.5% required repeat procedure.2 The mean blood loss during the procedure 33.75ml. there was no requirement of blood transfusion or additional uterotonics for hemostasis achievement. There were no cases of uterine perforation/ laceration of cervix. It is a rapid procedure with the mean duration of 5.93 minutes. There was no need for anaesthesia and done in an office setup.

Conclusion: MVA is safe, portable, rapid office procedure requiring no anaesthesia and hence the need for access to operation theatre and decreased hospital stay.2

Keywords: Manual vacuum aspiration, Uterotonics, Incomplete abortion.

References

  1. Nasheed Rahim, Anjum Ara: The use of Manual Vacuum Aspiration for treatment of first trimester abortion; J. Med. SCi. (Peshawar, print) July 2014, vol.22, No.3.
  2. DS Milingos M Mathur, Nc Smith, PW Ashok: Manual vacuum aspiration: a safe alternative for the surgical management of early pregnancy loss. BJOG: An International Journal of Obstetrics & Gynaecology vol 116, issue 9, august 2009. Pgs 1268-1271.
  3. World Health Organization, United Nations Children’s funds, Maternal mortality in 1995. Geneva: World Health Organization:2001.
  4. Farook F, Javed L, Mutaz A, Naveed N, Comparison of manual vacuum aspiration and dilatation and curettage in the treatment of early pregnancy failure J Ayub Med Coll Abbotabaf 2011; 23(3): 28-31.
  5. World Health Organization. Safe abortion: Technical and policy guidelines for Health systems. Geneva, Switzerland: WHO,2003.
  6. Wen J, Cai Q, Deng F, Li Y. Manual versus electric vacuum aspiration for first trimester abortion: a systematic review. BJOG 2008;115:5-13.
  7. Tasnim N, Mahmud G, Fatima S, Sultan M, Manual vacuum aspiration: a safe and alternative substitute of electric vacuum aspiration for the surgical management of early pregnancy loss. J Pak Med Assoc. 20011:61: 149-53.
  8. Das C M, Srichand P, Khursheed F, Shaikh F. assessment of safety and efficacy of MVA. J Liaquat Uni Med Health Sci. 2010,9:130-3.
  9. Gazvani R< Honey E, Maclennan FM. Manual Vacuum Aspiration in the management of first trimester pregnancy loss. Eur J Obstet Gynecol Reprod Biol.2004; 112: 197-200.
  10. Marshall BR. Emergency room vacuum curettage for incomplete abortion. J Reprod Med 1971;4:177-8.
  11. Brown HC, Jewkes R, Levin J, Dickson-Tetteh K, Rees H. management of incomplete abortion in South African Public hospitals. BJOG.2003; 110:371-7.

Corresponding Author

Dr Jayashree.V

Associate Professor, Department of Obstetrics and Gynaecology, Rajah Muthiah Medical College, Annamalai University, Chidambaram

Email:  This email address is being protected from spambots. You need JavaScript enabled to view it.