Cervical priming with misoprostol before manual vacuum aspiration versus electric vacuum aspiration for first‐trimester surgical abortion

Mittal, Suneeta; Sehgal, Rachna; Aggarwal, Shashi; Aruna, Janaki; Bahadur, Anupama; Kumar, Guresh

doi:10.1016/j.ijgo.2010.07.035

Cited by 10 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cervical priming with vaginal misoprostol before MVA has shown to significantly reduce the need for cervical dilation and improve the efficacy of the procedure [19]. For many of the elective patients in the study, the use of misoprostol alone before procedure was enough to ensure that the cervix was dilated, allowing safer evacuation by minimising cervical trauma related to instrumental dilation and reducing the discomfort of cervical dilation.…”

Section: Discussionmentioning

confidence: 97%

Manual vacuum aspiration under local anaesthetic for early miscarriage: 2 years experience in a university teaching hospital in UK

et al. 2013

View full text Add to dashboard Cite

Manual vacuum aspiration under local anaesthesia (MVA-LA) in an outpatient setting is an alternative to the standard surgical aspiration under general anaesthesia for miscarriage. We evaluate the feasibility, safety and clinical outcomes of MVA-LA in the management of miscarriage at less than 12 weeks of gestation in an outpatient setting. This prospective cohort study was conducted at the Birmingham Women's Hospital. One hundred and thirty-one women with ultrasound scan confirmed incomplete or missed miscarriage underwent MVA-LA between November 2010 and January 2013. A computer database was used to record relevant information. The mean gestation age was 8.3 weeks (±1.8). Successful evacuation was achieved in 100 % of cases. One hundred and fourteen (87 %) patients underwent the procedure with direct intracervical LA block and the remaining cases did not have LA. There were no reported complications in 96 % of procedures. Cervical injury and vasovagal symptoms noted in 3.8 % of cases. In all cases, vaginal bleeding was minimal or mild. The post-operative pain was controlled successfully with a combination of paracetamol and diclofenac in 82 % of patients. The MVA method was associated with high levels (93 %) of patient satisfaction and acceptability. MVA-LA in an outpatient setting is a safe and acceptable therapeutic option for women diagnosed with early missed or incomplete miscarriage.

show abstract

Section: Discussionmentioning

confidence: 97%

Manual vacuum aspiration under local anaesthetic for early miscarriage: 2 years experience in a university teaching hospital in UK

et al. 2013

View full text Add to dashboard Cite

show abstract

“…In general, differences between misoprostol and placebo in terms of operative time and blood loss are statistically, but not clinically, significant. The effectiveness of misoprostol is not influenced by whether manual vacuum aspiration or electric suction is used [140].…”

Section: Is Misoprostol Safe and Effective For Cervical Priming In Thmentioning

confidence: 96%

“…Several randomized trials have compared misoprostol and placebo or no therapy for cervical priming before firsttrimester surgical abortion and found that misoprostol increases baseline dilation and facilitates further dilation. These studies analyzed vaginal doses of 100 to 750 mcg [19,61,91,95,96,101,103,105,139,140], oral doses of 400 to 600 mcg [103,104,141] and a sublingual dose of 400 mcg [107,113,142]. Almost all of these studies demonstrated an increased baseline cervical dilatation with misoprostol, and some also found a greater subjective ease of dilation [19,95,104,[140][141][142], lower measured cumulative force with dilation [61,103], shorter procedure time [19,91,95,96,104,107,113] or lower estimated blood loss [103,104,107,113].…”

Section: Is Misoprostol Safe and Effective For Cervical Priming In Thmentioning

confidence: 99%

Cervical dilation before first-trimester surgical abortion (< 14 weeks' gestation)

Allen

Goldberg

2016

Contraception

View full text Add to dashboard Cite

First-trimester surgical abortion is a common, safe procedure with a major complication rate of less than 1%. Cervical dilation before suction abortion is usually accomplished using tapered mechanical dilators. Risk factors for major complications in the first trimester include increasing gestational age and provider inexperience. Cervical priming before first-trimester surgical abortion has been studied using osmotic dilators and pharmacologic agents, most commonly misoprostol. Extensive data demonstrate that a variety of agents are safe and effective at causing preoperative cervical softening and dilation; however, given the small absolute risk of complications, the benefit of routine use of misoprostol or osmotic dilators in first-trimester surgical abortion is unclear. Although cervical priming results in reduced abortion time and improved provider ease, it requires a delay of at least 1 to 3 h and may confer side effects. The Society of Family Planning does not recommend routine cervical priming for first-trimester suction abortion but recommends limiting consideration of cervical priming for women at increased risk of complications from cervical dilation, including those late in the first trimester, adolescents and women in whom cervical dilation is expected to be challenging.

show abstract

“…However, they were similar in the incidence of sepsis post procedure, uterine perforation, or the need for re-evacuation [21]. MVA and EVA do not appear to differ substantially in efficacy [22]. VA can be performed in the absence of a fully equipped facility and at secondary health facilities, with or without electricity, and without the capacity for general anesthesia.…”

Section: Vacuum Aspiration (Va)mentioning

confidence: 96%

“…VA can be performed in the absence of a fully equipped facility and at secondary health facilities, with or without electricity, and without the capacity for general anesthesia. It is suitable for low-income settings because it is more accessible and reduces the consequences of blood loss and worsening infection associated with transportation to tertiary health facilities [22].…”

Section: Vacuum Aspiration (Va)mentioning

confidence: 99%

Interventions for Failed Family Planning

Chien¹,

Au²

2018

Family Planning

View full text Add to dashboard Cite

Despite the introduction of family planning services in most areas of the world, failures of contraceptive use often lead to unplanned pregnancies. These women often resort to unsafe methods to end their pregnancies, which contributes to the fourth leading cause of maternal mortality worldwide. Demographic variables that may affect the intention to discontinue the pregnancies would be demonstrated. Pros and cons of different types of induced abortions would be presented and discussed. Programs integrating counseling for women after failed family planning for future comprehensive reproductive health care will be shown. The gap between women's reproductive desire to avoid pregnancy and altitude of contraceptive use may contribute to the prevalence of unintended pregnancy. Age, race/ethnicity, marital status, and socioeconomic characteristics should be considered in counseling women after failed family planning. Expanding the program that offers integrated abortion training would prepare more physicians to provide comprehensive care for family planning.

show abstract

Cervical priming with misoprostol before manual vacuum aspiration versus electric vacuum aspiration for first‐trimester surgical abortion

Abstract: CTRI/2009/091/000008.

Cited by 10 publications

References 18 publications

Manual vacuum aspiration under local anaesthetic for early miscarriage: 2 years experience in a university teaching hospital in UK

Manual vacuum aspiration under local anaesthetic for early miscarriage: 2 years experience in a university teaching hospital in UK

Cervical dilation before first-trimester surgical abortion (< 14 weeks' gestation)

Interventions for Failed Family Planning

Contact Info

Product

Resources

About