-
The New England Journal of Medicine Dec 2011
Review
Topics: Abortifacient Agents; Abortion, Induced; Antibiotic Prophylaxis; Female; Humans; Practice Guidelines as Topic; Pregnancy; Pregnancy Trimester, First; Vacuum Curettage; Young Adult
PubMed: 22150038
DOI: 10.1056/NEJMcp1103639 -
Texas Heart Institute Journal Nov 2022
Topics: Humans; Female; Mustard Plant; Vacuum Curettage
PubMed: 36448943
DOI: 10.14503/THIJ-20-7506 -
BJOG : An International Journal of... Jan 2008As an alternative to electric vacuum aspirations (EVA), there is an increasing interest in using manual vacuum aspiration (MVA). (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
As an alternative to electric vacuum aspirations (EVA), there is an increasing interest in using manual vacuum aspiration (MVA).
OBJECTIVE
To compare the safety, efficacy and acceptability of MVA with those of EVA for first-trimester abortion.
SEARCH STRATEGY
We searched MEDLINE, EMBASE, Cochrane Library and Chinese Biomedical Database in all language, together with reference lists of retrieved papers.
SELECTION CRITERIA
Randomised controlled trials comparing MVA with EVA for first-trimester abortion were included. The outcomes are complete abortion rate, uterine perforation rate, blood loss, pain perception and acceptability.
DATA COLLECTION AND ANALYSIS
Two reviewers independently extracted the data. Results from the trials were combined to calculate relative risks (RRs) or risk differences for dichotomous outcomes and weighted mean differences (WMDs) for continuous outcomes, together with 95% CIs.
MAIN RESULTS
Ten trials were included, involving 1660 women. Generally, the methodological quality was poor. There were no statistically significant differences, comparing MVA with EVA, in complete abortion rate (RR 1.00; 95% CI 0.99-1.02) and participants' satisfaction (RR 1.02; 95% CI 0.87-1.20). In participants with less than 50 days of gestational age, less blood loss (WMD -1.84; 95% CI -2.45 to -1.23) and less severe pain perception (RR 0.04; 95% CI 0.01-0.12) were reported during the MVA procedure, whereas the operation time was shorter (WMD 0.32; 95% CI 0.02-0.63) in the EVA procedure.
AUTHOR'S CONCLUSIONS
There is some evidence that MVA is as effective and acceptable as EVA and might be safer than EVA.
Topics: Abortion, Induced; Female; Humans; Pain; Patient Satisfaction; Postpartum Hemorrhage; Pregnancy; Pregnancy Trimester, First; Randomized Controlled Trials as Topic; Vacuum Curettage; Vacuum Extraction, Obstetrical
PubMed: 18053098
DOI: 10.1111/j.1471-0528.2007.01572.x -
Ceska Gynekologie 2021To describe the case of ectopic pregnancy in the scar after caesarean section and its successful treatment using the technique of sonographically controlled vacuum...
OBJECTIVE
To describe the case of ectopic pregnancy in the scar after caesarean section and its successful treatment using the technique of sonographically controlled vacuum aspiration.
CASE REPORT
The case of a 35-year-old patient with a history of two caesarean sections referred by a district gynecologist in the 6th week of pregnancy with suspected pathological localization of pregnancy in a scar after a previous caesarean section. The procedure for the diagnosis and treatment of ectopic pregnancy in the scar after previous caesarean sections has been successfully resolved using sonographically controlled vaginal vacuum aspiration.
CONCLUSION
Caesarean scar pregnancy occurs as a complication of previous caesarean section or other uterine instrumental performances. The use of the sonographically controlled vacuum aspiration technique appears to be a successful method of treating pregnancy in a scar after a caesarean section.
Topics: Adult; Cesarean Section; Cicatrix; Female; Humans; Pregnancy; Pregnancy, Ectopic; Ultrasonography, Interventional; Vacuum Curettage
PubMed: 34167311
DOI: 10.48095/cccg2021184 -
Obstetrics and Gynecology Apr 2018To evaluate uterine evacuation of patients with molar pregnancy, comparing manual with electric vacuum aspiration. (Comparative Study)
Comparative Study
OBJECTIVE
To evaluate uterine evacuation of patients with molar pregnancy, comparing manual with electric vacuum aspiration.
METHODS
This is a retrospective cohort study of patients with molar pregnancy followed at the Rio de Janeiro Trophoblastic Disease Center from January 2007 to December 2016. The individual primary study outcomes were incomplete uterine evacuation, uterine perforation, development of uterine synechia, and development of postmolar gestational trophoblastic neoplasia. Secondary endpoints were other features of the perioperative outcomes (operative time, rate of transfusion, hemoglobin change, length of stay) and the clinical course of neoplasia (Prognostic Risk Score, presence of metastases, time to remission, and need for multiagent chemotherapy).
RESULTS
Among 1,727 patients with molar pregnancy, 1,206 underwent electric vacuum aspiration and 521 underwent manual vacuum aspiration. After human chorionic gonadotropin normalization, patients with benign molar pregnancy were followed for 6 months and patients treated for gestational trophoblastic neoplasia were followed for 12 months. Baseline risk factors for gestational trophoblastic neoplasia and demographic features were similar between the treatment groups. Uterine synechia developed less frequently after manual vacuum aspiration than after electric vacuum aspiration, 6 of 521 vs 63 of 1,206 (adjusted odds ratio [OR] 0.21, 95% CI 0.09-0.49), despite no differences in the occurrence of incomplete uterine evacuation, 65 of 521 vs 161 of 1,206 (adjusted OR 0.93, 95% CI 0.69-1.27), development of postmolar gestational trophoblastic neoplasia, 90 of 521 vs 171 of 1,206 (adjusted OR 1.26, 95% CI 0.96-1.67), or the need for multiagent chemotherapy, 22 of 521 vs 41 of 1,206 (adjusted OR 0.81, 95% CI 0.73-1.28).
CONCLUSION
Manual vacuum aspiration appears to be similar to electric vacuum aspiration for treatment of molar pregnancy and may be associated with less development of uterine synechia.
Topics: Adolescent; Adult; Brazil; Child; Chorionic Gonadotropin; Female; Humans; Hydatidiform Mole; Logistic Models; Middle Aged; Multivariate Analysis; Neoplasm Staging; Pregnancy; Retrospective Studies; Risk Factors; Vacuum Curettage; Young Adult
PubMed: 29528932
DOI: 10.1097/AOG.0000000000002522 -
Obstetrics and Gynecology Oct 1985In this study of 33,090 suction curettage abortions performed at less than or equal to 12 weeks' gestation, the rate of unrecognized failed abortions was 2.3 per 1000...
In this study of 33,090 suction curettage abortions performed at less than or equal to 12 weeks' gestation, the rate of unrecognized failed abortions was 2.3 per 1000 abortions. Women with one or more prior pregnancies and those having an abortion at less than or equal to six weeks' gestation, particularly when small suction cannulae were used, were at higher risk for this complication (relative risks of 2.2, 2.9, and 11.1, respectively). Failures were also more likely when abortions were performed by resident physicians (relative risk of 2.2) and when they were performed on women with uterine anomalies (relative risk of 90.6). Physicians can minimize the risk of failed abortion by selecting an appropriate suction cannula size and by planning the optimal time to perform the abortion. Likewise, abortions performed either by residents or on women with uterine anomalies merit extra care.
Topics: Abortion, Legal; Abortion, Missed; Adolescent; Adult; Dilatation and Curettage; Female; Humans; Parity; Pregnancy; Pregnancy Trimester, First; Racial Groups; Reoperation; Risk; United States; Vacuum Curettage
PubMed: 4047543
DOI: No ID Found -
Obstetrics and Gynecology Jul 2004We describe present methods for induced abortion used in the United States. The most common procedure is first-trimester vacuum curettage. Analgesia is usually provided... (Review)
Review
We describe present methods for induced abortion used in the United States. The most common procedure is first-trimester vacuum curettage. Analgesia is usually provided with a paracervical block and is not completely effective. Pretreatment with nonsteroidal analgesics and conscious sedation augment analgesia but only to a modest extent. Cervical dilation is accomplished with conventional tapered dilators, hygroscopic dilators, or misoprostol. Manual vacuum curettage is as safe and effective as the electric uterine aspirator for procedures through 10 weeks of gestation. Common complications and their management are presented. Early abortion with mifepristone/misoprostol combinations is replacing some surgical abortions. Two mifepristone/misoprostol regimens are used. The rare serious complications of medical abortion are described. Twelve percent of abortions are performed in the second trimester, the majority of these by dilation and evacuation (D&E) after laminaria dilation of the cervix. Uterine evacuation is accomplished with heavy ovum forceps augmented by 14-16 mm vacuum cannula systems. Cervical injection of dilute vasopressin reduces blood loss. Operative ultrasonography is reported to reduce perforation risk of D&E. Dilation and evacuation procedures have evolved to include intact D&E and combination methods for more advanced gestations. Vaginal misoprostol is as effective as dinoprostone for second-trimester labor-induction abortion and appears to be replacing older methods. Mifepristone/misoprostol combinations appear more effective than misoprostol alone. Uterine rupture has been reported in women with uterine scars with misoprostol abortion in the second trimester. Fetal intracardiac injection to reduce multiple pregnancies or selectively abort an anomalous twin is accepted therapy. Outcomes for the remaining pregnancy have improved with experience.
Topics: Abortion, Induced; Dilatation; Female; Humans; Labor, Induced; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Vacuum Curettage
PubMed: 15229018
DOI: 10.1097/01.AOG.0000130842.21897.53 -
BMJ Sexual & Reproductive Health Oct 2021
Topics: Abortion, Induced; COVID-19; Female; Humans; Pregnancy; SARS-CoV-2; Vacuum Curettage
PubMed: 33504511
DOI: 10.1136/bmjsrh-2020-200945 -
European Journal of Obstetrics,... Nov 2021Manual Vacuum Aspiration (MVA) is a well-established management option for early pregnancy loss or early termination of pregnancy. MVA is performed as out-patient...
OBJECTIVE
Manual Vacuum Aspiration (MVA) is a well-established management option for early pregnancy loss or early termination of pregnancy. MVA is performed as out-patient surgical procedure using local anaesthetic whereby aspiration of uterine contents is achieved through use of a hand-held negative pressure syringe. Ireland's first MVA service was established at the Rotunda Hospital Dublin in April 2020,. The purpose of this study was to gather feedback from women who had undergone MVA in the unit.
STUDY DESIGN
Prospective mixed methods study of women attending for uterine aspiration under local anaesthetic from July to October 2020 in the unit. Consenting women were contacted one week following MVA via telephone. The survey conducted consisted of structured closed questions along with open-ended questions, to assess womens satisfaction in relation to all aspects of the MVA service.
RESULTS
Nineteen women took part in the study, a response rate of 86.4%. Participants reported feeling well informed prior to attending for MVA. Prior to the procedure, pain expectation scores were high but actual reported pain scores were much lower. Although some participants did find MVA uncomfortable, the fact the procedure was very quick and the side effects so minimal generally negated this. The location and set up of the clinic scored highly among participants as did the staff of the clinic. Overall satisfaction with the MVA service was high with 84.2% of participants reporting they would opt again for MVA in the future.
CONCLUSIONS
Women living in Ireland are interested and agreeable with having Manual Vacuum Aspiration as an available option for management of early pregnancy complications. Consideration should be given to expansion of MVA services nationally.
Topics: Abortion, Induced; Abortion, Spontaneous; Anesthesia, Local; Female; Humans; Patient Satisfaction; Pregnancy; Prospective Studies; Vacuum Curettage
PubMed: 34624739
DOI: 10.1016/j.ejogrb.2021.09.008 -
Obstetrics and Gynecology Jan 2004Manual vacuum aspiration is an alternative to electric suction curettage for first-trimester elective abortion. Although many studies have demonstrated that manual... (Comparative Study)
Comparative Study
OBJECTIVE
Manual vacuum aspiration is an alternative to electric suction curettage for first-trimester elective abortion. Although many studies have demonstrated that manual vacuum aspiration is safer than sharp curettage for abortion, only a few studies have directly compared it with electric suction curettage. These studies proved the methods to be equally effective and acceptable but were too small to adequately compare safety. We compared immediate complication rates for abortions performed by manual and electric vacuum aspiration.
METHODS
We conducted a retrospective cohort analysis of all women undergoing elective abortion at up to 10 weeks' gestation at San Francisco General Hospital over a 3.5-year period. A total of 1726 procedures were included: 1002 manual and 724 electric vacuum aspirations. Clinical data were collected from medical records. Rates of uterine reaspiration and other immediate complications occurring at our institution were compared.
RESULTS
We found no difference in the rate of uterine reaspiration after abortions performed with the manual or electric suction device (2.2% versus 1.7%, respectively, P =.43). We had 80% statistical power to detect a 2% difference in uterine reaspiration rates with an microa error of.05. Overall major complication rates were 2.5% with manual and 2.1% with electric suction curettage, P =.56. Multivariable regression analyses controlling for potential confounders showed no difference in uterine reaspiration rates (electric odds ratio [OR] = 0.71, 95% confidence interval [CI] 0.32, 1.6) or overall complications (electric OR = 0.81, 95% CI 0.40, 1.7).
CONCLUSION
Manual vacuum aspiration is as safe as electric suction curettage for abortions at up to 10 weeks' gestation. Expanded use in an office setting might increase abortion access.
Topics: Abortion, Induced; Adult; Blood Loss, Surgical; Cohort Studies; Equipment Design; Female; Gestational Age; Humans; Medical Records; Postoperative Complications; Pregnancy; Pregnancy Trimester, First; Reoperation; Retrospective Studies; San Francisco; Vacuum Curettage
PubMed: 14704252
DOI: 10.1097/01.AOG.0000109147.23082.25