Manual vacuum aspiration (MVA) in the management of first trimester pregnancy loss.
BACKGROUND
Manual vacuum aspiration is not widely used for the evacuation of retained products of conception in western Europe despite its well-proven success and safety record. Nor is there much information about its use under intravenous (systemic) analgesia or patient-controlled anaesthesia in modern settings.


OBJECTIVE
To evaluate the use of manual vacuum aspiration for the evacuation of retained products of conception under systemic analgesia or patient-controlled anaesthesia in the management of first trimester miscarriages.


METHODS
Fifty-eight women with a diagnosis of first trimester miscarriage (42 missed and 16 incomplete miscarriages) were treated with manual vacuum aspiration under systemic analgesia or patient-controlled anaesthesia. Success rates and patient satisfaction and acceptability were recorded.


RESULTS
Of the 58 women recruited, 42 underwent the procedure under systemic analgesia and 15 under patient-controlled sedation while 1 woman opted for general anaesthesia. Successful evacuation was achieved in all cases. Both analgesic methods were associated with high levels of patient satisfaction and acceptability.


CONCLUSIONS
Manual vacuum aspiration is an option in the management of all first trimester pregnancy losses. Comparisons with other treatment options are indicated.
Gazvani
Rafet
R
Department of Obstetrics and Gynaecology, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK. gazvani@hotmail.com
Honey
Emma
E
MacLennan
Fiona M
FM
Templeton
Allan
A
D000026:Abortion, Habitual / Q000601:surgery; D000027:Abortion, Incomplete / Q000601:surgery*; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000758:Anesthesia / Q000379:methods*; D000771:Anesthesia, Intravenous; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008423:Maternal Age; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014619:Vacuum Curettage / Q000379:methods*
D000700:Analgesics