Efficacy, feasibility and patient acceptability of ultrasound‐guided manual vacuum aspiration for treating early pregnancy loss

Chung, Jacqueline Pui Wah; Chung, Cathy Hoi Sze; Mak, Jennifer Sze Man; Li, Tin‐Chiu; Kong, Grace

doi:10.1111/ajo.12811

Cited by 12 publications

(12 citation statements)

References 23 publications

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“…In one review, Grewal et al performed a randomized controlled trial showing that complication rates were lower for surgical termination of pregnancy performed under ultrasound guidance than for surgical termination of pregnancy without ultrasound guidance 12 . This has been confirmed by other studies 12–15 . In the present study, the incidence of surgical complications in the ultrasound group was lower than that in the non‐ultrasound group (1% vs. 14%), and the difference was statistically significant (Table 3 and Table 4).…”

Section: Discussionsupporting

confidence: 82%

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Safe abortion: A retrospective study of negative pressure suction in abortion under the monitoring of ultrasound

Qiao

2022

Intl J Gynecology & Obste

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Safe abortion is an important aspect of reproductive health, and unsafe abortion remains a growing female problem, a public health problem, and one of the leading causes of maternal mortality in many developing countries. 1,2 Worldwide, 25% of pregnancies end in abortion and more than 50 million abortions are performed annually. 3 The consequences of unsafe abortion include not only physical but also psychological problems. 4 Internationally, safe abortion and high-quality periabortion management can curb maternal deaths, [5][6][7][8] with stricter periabortion period management employed for women with repeat abortions. 9

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Section: Discussionsupporting

confidence: 82%

“…12 This has been confirmed by other studies. [12][13][14][15] In the present study, the incidence of surgical complications in the ultrasound group was lower than that in the non-ultrasound group (1% vs. 14%), and the difference was statistically significant (Table 3 and Table 4). This also confirms the findings from previous studies.…”

Section: Discussionmentioning

confidence: 41%

Safe abortion: A retrospective study of negative pressure suction in abortion under the monitoring of ultrasound

Qiao

2022

Intl J Gynecology & Obste

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“…Last, we also acknowledge the evidence basis for the safety of manual vacuum aspiration, which was temporarily not performed at our institution during this timeframe. Indeed, previous authors have demonstrated similarly low complication rates with MVA when compared to EVA [ 15 – 17 ], suggesting that inferences of the benefit of transvaginal ultrasonography in this population can be made as well.…”

Section: Discussionmentioning

confidence: 87%

The implementation of routine procedural transvaginal sonography to decrease retained products of conception: a quality improvement initiative

et al. 2021

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Background Retained products of conception (POC) following uterine evacuation can lead to adverse sequelae, including hemorrhage, endometritis, intrauterine adhesions, and reoperation. Use of procedural transvaginal sonography (TVUS) in the operating room has been proposed to help decrease retained POC. Methods A retrospective review of all first trimester uterine evacuation procedures from 1/2015 to 2/2017 was performed, noting use of transabdominal ultrasonography, retained products of conception, and complications. A practice change was implemented in May 2018, in which routine intra-procedural TVUS use was initiated. A second retrospective chart review was conducted to assess for post-implementation incidence of retained POC, re-operation, and associated complications. Results Prior to intra-procedural TVUS implementation, 130 eligible procedures were performed during the specified timeframe, with 9/130 (6.9%) incidence of retained products of conception. TAUS was performed in 59/130 (45.4%) of procedures, and 4/9 (44.4%) of those with retained products. There were eight re-operative procedures in seven patients, and two patients were treated with misoprostol. Complications included hemorrhage, Asherman’s syndrome and endometritis. Following implementation, 95 first trimester procedures were performed with transvaginal sonography, with 0 (0%) cases of retained POC (p = 0.01), no incidences of re-operation (p = 0.02), and one case of Asherman’s syndrome. TVUS findings led to additional focused suction curettage in 20/95 (21.0%) of procedures. The endometrium was measured on procedure completion in 64 procedures, with a mean thickness of 5.5 mm (1–12 mm). Conclusion Implementation of routine TVUS during uterine evacuation may reduce the incidence of retained POC and associated reoperation rates. Further multi-center trials are needed to confirm this finding.

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“…With the efficacy of 97.1 %, it was achievable in office settings and was associated with a high degree of patient satisfaction with many advantages over medical management with Misoprostol. 15 After completion of the procedure, the products of conception are collected in a kidney tray. The additional benefit of MVA was obtaining products of the conception of 94.3% for cytogenetic analysis.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Feasibility, Efficacy and Patient Acceptability of Manual Vacuum Aspiration Vs Sublingual Misoprostol in Early Pregnancy Loss

Arif

Zafar²,

Ahmed³

et al. 2022

PAFMJ

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Objective: To compare feasibility, efficacy and patient acceptability of manual vacuum aspiration with sublingual Misoprostol in early pregnancy loss. Study Design: Comparative prospective study. Place and Duration of Study: Gynecology and Obstetrics Department, Combined Military Hospital Okara Pakistan, from Aug 2019 to Apr 2020. Methodology: 200 Patients with early pregnancy loss (missed, incomplete abortion) at gestational age 6 to 12 weeks were randomly allocated to Manual vacuum aspiration (group A) and oral Misoprostol (group B) by lottery methods. Manual vacuum aspiration was done in the outpatient department. While in Group B, oral Misoprostol was given with a protocol 600 micro gram sublingual stat observe for 1 hour for any complication. Afterwards, they were given Misoprostol 600 micrograms sublingual, 3 hourly total of 2 doses. Patients from both groups were called for follow-up after one week. Results: Efficacy, feasibility and patient acceptability was 88%; p-value <0.001, 95%; p-value <0.001 and 97% respectively in manual vacuum aspiration group as compared to 64%, 68% and 70% in sublingual Misoprostol group. There were fewer systemic side effects and fewer visits in manual vacuum aspiration group 1 vs 3 in the sublingual Misoprostol group. Conclusion: Manual vacuum aspiration is more effective than Misoprostol as it has no systemic effects. Both options are cheap and can be achieved in outpatient settings. However, manual vacuum aspiration provides complete evacuation and is a good option for low resource settings and a developing country like Pakistan with frequent electricity disruptions. It offers a substantial saving on resources, cost and...

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Efficacy, feasibility and patient acceptability of ultrasound‐guided manual vacuum aspiration for treating early pregnancy loss

Cited by 12 publications

References 23 publications

Safe abortion: A retrospective study of negative pressure suction in abortion under the monitoring of ultrasound

Safe abortion: A retrospective study of negative pressure suction in abortion under the monitoring of ultrasound

The implementation of routine procedural transvaginal sonography to decrease retained products of conception: a quality improvement initiative

Comparison of Feasibility, Efficacy and Patient Acceptability of Manual Vacuum Aspiration Vs Sublingual Misoprostol in Early Pregnancy Loss

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