Manual Vacuum Aspiration (Mva); Safety and Effectiveness in the Treatment of First Trimester Pregnancy Loss

Abstract

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 outbreaks are common and advanced medical equipment is not available.