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International Journal of Gynecological... Sep 2021
Topics: Female; Humans; Hydatidiform Mole; Pregnancy; Vacuum Curettage
PubMed: 34049976
DOI: 10.1136/ijgc-2021-002631 -
Journal of Obstetrics and Gynaecology... Dec 1975
Topics: Abortion, Induced; Adolescent; Adult; Dilatation and Curettage; Embryonic Development; Family Planning Services; Female; Humans; Menstruation; Pregnancy; Pregnancy Trimester, First; Time Factors; Vacuum Curettage
PubMed: 1228034
DOI: No ID Found -
The Journal of Obstetrics and... Apr 2021To evaluate the risk factors and incidence of Asherman Syndrome in women with post-abortion uterine evacuation and curettage.
AIM
To evaluate the risk factors and incidence of Asherman Syndrome in women with post-abortion uterine evacuation and curettage.
METHODS
A total of 2546 patients who had surgical abortion (uterine evacuation and curettage) before the 20th gestational week with indications of missed abortion, anembryonic pregnancy, incomplete abortion, and elective curettage in a tertiary antenatal care center were recruited. The patients were called and surveyed for their symptoms; including infertility, oligo-amenorrhea and recurrent pregnancy loss, preterm birth and intrauterine growth retardation and abnormal placentation as criteria of Asherman Syndrome. Diagnostic (office) hysteroscopy was performed for 177 who had one of those complaints.
RESULTS
The incidence of Asherman Syndrome was 1.6% (n = 43/2546). History of ≥3 abortions was the main factor that increased the risk of Asherman Syndrome for by 4.6 times. Use of vacuum aspiration or sharp curettage, premedication for cervical priming, and having a pregnancy >10th gestational weeks were not risk factors for Asherman Syndrome.
CONCLUSION
When the diagnosis was based on presence of symptoms who underwent uterine instrumentation, the incidence of Asherman Syndrome was found to be 1.6%. Repeated abortions were the main risk factor for Asherman Syndrome and avoiding from repeated uterine instrumentations may have a role in prevention.
Topics: Curettage; Dilatation and Curettage; Female; Gynatresia; Humans; Incidence; Infant, Newborn; Pregnancy; Premature Birth; Risk Factors; Vacuum Curettage
PubMed: 33462894
DOI: 10.1111/jog.14667 -
Annals of Emergency Medicine Dec 1982
Topics: Abortion, Incomplete; Abortion, Spontaneous; Dilatation and Curettage; Emergency Medicine; Female; Humans; Pregnancy; Vacuum Curettage
PubMed: 7149367
DOI: 10.1016/s0196-0644(82)80270-9 -
Journal of Neurointerventional Surgery Jan 2020Improved functional outcomes after mechanical thrombectomy for emergent large vessel occlusion depend on expedient reperfusion after clinical presentation. Device... (Comparative Study)
Comparative Study
INTRODUCTION
Improved functional outcomes after mechanical thrombectomy for emergent large vessel occlusion depend on expedient reperfusion after clinical presentation. Device technology has improved substantially over the years, and several commercial options exist for both large-bore aspiration catheters and suction pump systems.
OBJECTIVE
To compare various vacuum pumps and examine the aspiration forces they generate as well as the force of catheter tip detachment from an artificial thrombus.
METHODS
Using an artificial thrombus made from polyvinyl alcohol gel, we tested various mechanical characteristics of commercially available suction pumps, including the Penumbra Jet Engine, Penumbra Max, Stryker Medela AXS, Microvention Gomco, and a 60 cc syringe. Both aspiration pressure and tip force generated were analyzed. Subsequently, a cohort of thrombectomy catheters were assessed using the Penumbra Jet Engine to determine tip forces generated on an artificial thrombus. One-way analysis of variance was used to assess statistical significance.
RESULTS
The Penumbra Jet Engine system generated both the highest maximum aspiration pressures (28.8 inches Hg) and the highest tip force (23.68 grams force (gf)) on an artificial thrombus, with statistical significance compared with the other pump systems. Using the Jet Engine, the largest-bore catheter was associated with the highest tip force (32.12 gf). The overall correlation coefficient between catheter inner diameter and tip force was 0.98.
CONCLUSIONS
The Penumbra Jet Engine pump generates significantly higher vacuum pressures and tip forces than the other commercially available aspiration pump systems. Furthermore, catheters with a larger inner diameter generate higher tip suction forces on aspiration. Whether these mechanical features lead to improved clinical outcomes is yet to be determined.
Topics: Catheters; Humans; Suction; Syringes; Thrombectomy; Treatment Outcome; Vacuum Curettage
PubMed: 31273074
DOI: 10.1136/neurintsurg-2019-014929 -
PloS One 2014To investigate the use of manual vacuum aspiration in postabortion care in Malawi between 2008-2012.
OBJECTIVES
To investigate the use of manual vacuum aspiration in postabortion care in Malawi between 2008-2012.
METHODS
A retrospective cross-sectional study was done at the referral hospital Queen Elisabeth Central Hospital, and the two district hospitals of Chiradzulu and Mangochi. The data were collected simultaneously at the three sites from Feb-March 2013. All records available for women admitted to the gynaecological ward from 2008-2012 were reviewed. Women who had undergone surgical uterine evacuation after incomplete abortion were included and the use of manual vacuum aspiration versus sharp curettage was analysed.
RESULTS
Altogether, 5121 women were included. One third (34.2%) of first trimester abortions were treated with manual vacuum aspiration, while all others were treated with sharp curettage. There were significant differences between the hospitals and between years. Overall there was an increase in the use of manual vacuum aspiration from 2008 (19.7%) to 2009 (31.0%), with a rapid decline after 2010 (28.5%) ending at only 4.9% in 2012. Conversely there was an increase in use of sharp curettage in all hospitals from 2010 to 2012.
CONCLUSION
Use of manual vacuum aspiration as part of the postabortion care in Malawi is rather low, and decreased from 2010 to 2012, while the use of sharp curettage became more frequent. This is in contrast with current international guidelines.
Topics: Abortion, Induced; Adult; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Hospitals, Public; Humans; Malawi; Patient Care; Pregnancy; Retrospective Studies; Vacuum Curettage
PubMed: 24963882
DOI: 10.1371/journal.pone.0100728 -
Journal of Gynecology Obstetrics and... Dec 2022Caesarean scar pregnancy (CSP), which is a direct consequence of caesarean delivery, can lead to serious complications such as placenta acreta spectrum (PAS). The aim of...
OBJECTIVE
Caesarean scar pregnancy (CSP), which is a direct consequence of caesarean delivery, can lead to serious complications such as placenta acreta spectrum (PAS). The aim of this study is to assess the effectiveness of ultrasound-guided suction curettage followed by foley balloon tamponade for the management of CSP in the first trimester of pregnancy.
STUDY DESIGN
A retrospective evaluation of 32 women who were managed with ultrasound-guided suction curettage and foley balloon catheter insertion to the CSP region was performed. The primary outcome of the study was the rate of successful termination of CSP without need of additional surgical intervention. Secondary outcomes were the rate of haematocrit decrease, duration of hospitalization and need for transfusion.
RESULTS
The described procedure was performed successfully without need for additional interventions for all patients. Median decrease in the haematocrit level post-operatively was 4% (2.25-5). Median hospitalization time was 1 day (1-2).
CONCLUSIONS
Ultrasound-guided suction curettage followed by foley balloon tamponade is an effective and safe method for the management of CSP. Direct comparative studies with other methods are required for a more precise conclusion.
Topics: Pregnancy; Humans; Female; Vacuum Curettage; Cicatrix; Retrospective Studies; Pregnancy, Ectopic; Cesarean Section; Ultrasonography, Interventional; Catheters
PubMed: 36087926
DOI: 10.1016/j.jogoh.2022.102471 -
PloS One 2023Approximately one in four women will experience a miscarriage in their lifetime. Ultrasound-guided manual vacuum aspiration (USG-MVA) is an ideal outpatient surgical...
BACKGROUND AND AIM
Approximately one in four women will experience a miscarriage in their lifetime. Ultrasound-guided manual vacuum aspiration (USG-MVA) is an ideal outpatient surgical treatment alternative to traditional surgical evacuation. We aimed to examine the cost-effectiveness of US-MVA with cervical preparation for treatment of early pregnancy loss from the perspective of public healthcare provider of Hong Kong.
METHODS
A decision-analytic model was designed to simulate outcomes in a hypothetical cohort of patients with early pregnancy loss on four interventions: (1) US-MVA, (2) misoprostol, (3) surgical evacuation of uterus by dilation and curettage (surgical evacuation), and (4) expectant care. Model inputs were retrieved from published literature and public data. Model outcome measures were total direct medical cost and disutility-adjusted life-year (DALY). Base-case model results were examined by sensitivity analysis.
RESULTS
The expected DALYs (0.00141) and total direct medical cost (USD736) of US-MVA were the lowest of all interventions in base-case analysis, and US-MVA was the preferred cost-effective option. One-way sensitivity analysis showed that the misoprostol group became less costly than the US-MVA group if the evacuation rate of misoprostol (base-case value 0.832) exceeded 0.920. In probabilistic sensitivity analysis, At the willingness-to-pay (WTP) threshold of 49630 USD/DALY averted (1x gross domestic product per capita of Hong Kong), the US-MVA was cost-effective in 72.9% of the time.
CONCLUSIONS
US-MVA appeared to be cost-saving and effective for treatment of early pregnancy loss from the perspective of public healthcare provider of Hong Kong.
Topics: Pregnancy; Female; Humans; Abortion, Spontaneous; Misoprostol; Vacuum Curettage; Cost-Effectiveness Analysis; Pregnancy Trimester, First; Ultrasonography, Interventional; Cost-Benefit Analysis
PubMed: 37922290
DOI: 10.1371/journal.pone.0294058 -
Acta Obstetricia Et Gynecologica... Jun 2001Vacuum aspiration has become standard surgical procedure for safe early pregnancy termination. Most of these operations are performed in the operating theater using... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
BACKGROUND AND OBJECTIVE
Vacuum aspiration has become standard surgical procedure for safe early pregnancy termination. Most of these operations are performed in the operating theater using suction curettage and an electric vacuum pump. MVA (manual vacuum aspiration) is an alternative that is well suited for use as a clinical procedure, which could have advantages both for the patient and the health care system. In order to compare conventional VA and MVA in a Swedish setting, a randomized study was undertaken.
METHODS
Two hundred women requesting abortion in early pregnancy, gestational age less than 56 days, and choosing surgical termination, were randomized to VA or MVA. Main study outcome was frequency of complete abortion but also other variables were recorded.
RESULTS
There were no significant differences between the two groups regarding background characteristics. Altogether 91 MVA and 88 VA operations were performed. There was no significant difference in frequency of complete abortion; two patients in each group subsequently needed re-curettage because of incomplete evacuation. No case of ongoing pregnancy occurred. Two patients in each group received treatment for endometritis. No other complications were recorded.
CONCLUSION
This study indicates that MVA is effective in emptying the uterine cavity, on par with the standard vacuum aspiration. The rate of complications with MVA was on the same low level as with conventional VA.
Topics: Abortion, Induced; Abortion, Therapeutic; Adolescent; Adult; Female; Follow-Up Studies; Humans; Middle Aged; Patient Satisfaction; Pregnancy; Pregnancy Trimester, First; Suction; Sweden; Treatment Outcome; Vacuum Curettage
PubMed: 11380295
DOI: No ID Found -
Journal of Gynecology Obstetrics and... Feb 2023There is still no consensus on a safe and efficient treatment modality for cesarean scar pregnancy (CSP), which is known to cause severe complications, such as...
OBJECTIVE
There is still no consensus on a safe and efficient treatment modality for cesarean scar pregnancy (CSP), which is known to cause severe complications, such as life-threatening hemorrhage. Suction curettage (SC) has been used as the first-line treatment for CSP with controversial outcomes. In this context, the objective of this study is to analyze the efficacy of SC in the treatment of CSP.
METHODS
The sample of this retrospective study consisted of 64 CSP patients treated using SC between 2012 and 2022. Patients' demographic and clinical variables, including the thickness of the myometrium at the lower uterine segment between the urinary bladder and cesarean scar, were obtained from their medical records. The study's primary outcome was determined as the success rate of SC. Accordingly, the patients were categorized into two groups: successful SC (Group 1) and unsuccessful SC (Group 2).
RESULTS
The success rate of SC was determined as 78.1%. The number of previous cesarean deliveries, gestational age, baseline beta-human chorionic gonadotropin (β-hCG) values, and endometrial thickness was significantly higher in Group 2 (p<0.05 for all), whereas the fetal cardiac activity and absence of an embryonic pole were significantly higher in Group 2 (p = 0.001 and p = 0.004, respectively). There was no significant difference between the groups in the thickness of the myometrium at the lower uterine segment (p = 0.890). The hemoglobin levels decreased significantly after SC in both Groups 1 and 2 (p<0.001 and p = 0.009, respectively). There was no significant difference between the groups in preoperative and postoperative hemoglobin values and the decrease in hemoglobin levels (p>0.05).
CONCLUSION
The study findings did not indicate any significant correlation between myometrial thickness at the lower uterine segment and the efficacy of SC in CSP patients. On the other hand, the number of cesarean deliveries, gestational age, baseline β-hCG values, endometrium thickness, fetal cardiac activity, and embryonic pole may be used to predict the outcome of SC in the treatment of CSP.
Topics: Pregnancy; Female; Humans; Vacuum Curettage; Retrospective Studies; Cicatrix; Pregnancy, Ectopic; Chorionic Gonadotropin, beta Subunit, Human
PubMed: 36592889
DOI: 10.1016/j.jogoh.2022.102531