Patient acceptability of manual versus electric vacuum aspiration for early pregnancy loss.
OBJECTIVE
To compare the safety, efficacy, postprocedure quality of life, and acceptability of manual vacuum aspiration (MVA) performed as an outpatient with electric vacuum aspiration (EVA) performed in a hospital in women experiencing a first-trimester miscarriage.


METHODS
From a randomized multicenter trial comparing misoprostol with vacuum aspiration for first-trimester loss, data were extracted comparing the safety, efficacy, and acceptability of MVA in an office setting with local anesthesia with EVA in an operating room environment with spinal or general anesthesia or monitored anesthesia care (MAC).


RESULTS
One hundred fifty-seven women underwent EVA or MVA. Efficacy and safety were similar in both groups. Physical and emotional role functioning scores were better in patients undergoing MVA (p=0.01), and fewer patients undergoing MVA missed work or required help at home (p<0.01). However, pain severity scores were better in the EVA arm of the study (p=0.03). There was a trend toward fewer MVA patients recommending or using this procedure again.


CONCLUSIONS
In patients with early pregnancy loss, treatment with MVA as an outpatient with local anesthesia is an effective and safe alternative to EVA performed in a hospital with conscious sedation or spinal or general anesthesia. Treatment in the outpatient setting allows for a better physical and emotional quality of life postprocedure.
Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. sedwards@obgyn.upenn.edu
Scott
S
Edwards
Richard
R
Tureck
Margaret
M
Fredrick
Xiangke
X
Huang
Jun
J
Zhang
Kurt
K
Barnhart
D000028:Abortion, Induced / Q000379:methods* / Q000706:statistics & numerical data; D000328:Adult; D005260:Female; D006801:Humans; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012720:Severity of Illness Index; D013396:Suction / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014619:Vacuum Curettage / Q000706:statistics & numerical data*; D014620:Vacuum Extraction, Obstetrical / Q000706:statistics & numerical data*; D016387:Women's Health