MANUAL VACUUM ASPIRATION (MVA)

SAFETY AND EFFECTIVENESS IN THE TREATMENT OF FIRST TRIMESTER PREGNANCY LOSS

Abstract

Objectives: To determine the safety and effectiveness of manual vacuum
aspiration (MVA) in treating first trimester pregnancy loss. Place & duration of study: Department
of Gynecology, Shahina Jamil Teaching Hospital, Abbottabad, Pakistan, from September
2013 to December 2014. Study design: Descriptive cross-sectional study. Materials and
methods: All the patients who were less than 12 weeks of gestation and diagnosed with missed
abortion, incomplete abortion, having retained products of conception after normal delivery
and anembryonic pregnancy were included in the study. Diagnosis was made on the basis of
history, physical examination and ultrasonography. Urine pregnancy test and β-HCG were done
in selected patients. Last menstrual period and USG were used to determine the gestational
age. Manual vacuum aspiration was carried out under Para cervical block using “Ipas Easy
Grip” cannula with a 60ml syringe attached to it to create a negative pressure. Completeness
of the procedure was determined and products of conception were sent for histopathological
examination. Results: There were 165 patients enrolled in this study. All study subjects were
married. Mean age of the patients was 27.60± 4.86 years. Fifty patients had a previous history
of abortion. Mean parity was 2.98± 2.22 and mean gestational age was 8.23±1.6 weeks.
The maximum number of patients, 80%, belonged to age group of 20-30 years. There were
37 patients who were presented with first pregnancy. The number of multigravida and grand
multigravida patients were equal, 64 cases in each group. The main reason for undergoing
MVA in our study subjects was missed and incomplete abortion followed by retained products
of conception and anembryonic pregnancy. Conclusion: MVA is a preferred mode of treating
first trimester pregnancy loss as it is a simple, safe and cost-effective procedure. MVA should be
used preferentially in rural areas where there is a limited access to health care facilities, power
out-breaks are common and advanced medical equipment is not available.