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Revista Da Associacao Medica Brasileira... 2006To compare manual vacuum aspiration (MVA) and uterine curettage (D and C) for first trimester abortions, in terms of the efficiency of eliminating ovular remnants,... (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVES
To compare manual vacuum aspiration (MVA) and uterine curettage (D and C) for first trimester abortions, in terms of the efficiency of eliminating ovular remnants, frequency of complications, duration of the procedure, and duration of patients' hospitalization.
METHODS
In a prospective study, 50 patients in the MVA group and 50 in the D&C group were randomly included. Inclusion criteria were: spontaneous abortion, gestational age less than 13 weeks, patent cervix, endometrial thickness >15 mm, afebrile state, and hemoglobin >10 g/dl. Blood samples were collected before and after surgical procedures for control of hemoglobin levels. Anesthesia was performed in all cases. The time required for each surgical procedure was recorded.
RESULTS
Groups were similar regarding gestational age (9.93 +/- 2.40 vs 9.73 +/- 2.58 weeks; p = 0.71) and endometrial thickness before surgery (22.14 +/- 4.80 vs 22.68 +/- 5.68 mm; p = 0.65). There were no surgical or anesthetic complications in either group. Durations of the procedure and of hospitalization were significantly shorter in the MVA group (3.71 vs 10.18 min, p < 0.001, and 14.18 vs 23.06 h, p = 0.03, respectively). Decrease of hemoglobin levels was greater after the surgical procedure in the D and C group (p = 0.02).
CONCLUSION
MVA caused less blood loss, was less time consuming, and resulted in shorter hospitalization. However, both surgical procedures were found to be efficient for treatment of incomplete abortions during the first trimester of pregnancy, with no complications after both treatments.
Topics: Abortion, Incomplete; Adult; Analysis of Variance; Curettage; Female; Humans; Length of Stay; Pregnancy; Pregnancy Trimester, First; Prospective Studies; Statistics, Nonparametric; Time Factors; Treatment Outcome; Uterine Diseases; Vacuum Curettage
PubMed: 17160302
DOI: 10.1590/s0104-42302006000500015 -
Journal de Gynecologie, Obstetrique Et... Apr 2006While medical abortion is now available in non hospital facilities, abortions by vacuum aspiration remain illegal in non hospital settings. It is therefore important to... (Comparative Study)
Comparative Study Review
While medical abortion is now available in non hospital facilities, abortions by vacuum aspiration remain illegal in non hospital settings. It is therefore important to assess through the literature the real risks associated with this method. All the most recent and large-scale studies showed that legal abortion by vacuum aspiration is an extremely safe procedure. It is less risky than other medical or surgical procedures performed outside the hospital. According to the studies, the death rate varies from 0 to 0.7 per 100,000 abortions, and is smaller when the procedure is done under local anesthesia than general anesthesia. The overall early complication rate (hemorrhage, uterine perforation, cervical injury) is between 0.01 and 1.16%. Complications are not more frequent than with medical abortions. In view of these low complication rates, surgical abortion by vacuum aspiration could be performed outside the hospital setting in France, as it is the case in many other countries.
Topics: Abortion, Induced; Anesthesia, General; Anesthesia, Local; Cervix Uteri; Female; Humans; Pregnancy; Risk Factors; Uterine Hemorrhage; Uterus; Vacuum Curettage
PubMed: 16575361
DOI: 10.1016/s0368-2315(06)76389-x -
Danish Medical Bulletin Apr 1975
Topics: Adolescent; Adult; Aged; Denmark; Dilatation and Curettage; Evaluation Studies as Topic; Female; Genital Diseases, Female; Humans; Middle Aged; Postoperative Complications; Vacuum Curettage
PubMed: 1149505
DOI: No ID Found -
American Journal of Obstetrics and... Sep 1979We evaluated the cervical dilator device (CDD), an expanding balloon, as a substitute for laminaria tents before abortion at 13 to 16 1/2 weeks by extraction and vacuum...
We evaluated the cervical dilator device (CDD), an expanding balloon, as a substitute for laminaria tents before abortion at 13 to 16 1/2 weeks by extraction and vacuum curettage. The CDD was found to be an effective dilator, although it did not appear to have any advantage over laminaria tents when placed overnight and was associated with significant pain upon insertion and an apparent increased risk of endometritis. The present CDD or a subsequent modification may offer advantages over laminaria tents for short-term placement.
Topics: Abortion, Induced; Dilatation and Curettage; Endometritis; Evaluation Studies as Topic; Female; Humans; Pain; Pregnancy; Pregnancy Trimester, Second; Vacuum Curettage
PubMed: 474671
DOI: 10.1016/0002-9378(79)90343-0 -
African Health Sciences Mar 2022The risk of uterine perforation during manual vacuum aspiration (MVA) is reduced by using Karman cannula (which has a rounded tip) during the procedure.
BACKGROUND
The risk of uterine perforation during manual vacuum aspiration (MVA) is reduced by using Karman cannula (which has a rounded tip) during the procedure.
METHODS
A 35-year-old multigravida at 13 gestational weeks presented with vaginal bleeding of a day duration and ultrasound evidence of retained products of conception suggestive of incomplete miscarriage. The patient was rhesus D positive and stable. She had MVA which was performed using Karman cannula, and developed severe vaginal bleeding. The differential diagnoses were incomplete uterine evacuation and uterine perforation.
RESULTS
During a laparotomy in Lloyd-Davies position, haemoperitoneum and six uterine perforations on the anterior and fundal parts, each approximately 5 mm in length (Figure 1), were found. The perforations were repaired and a check uterine curettage under oxytocic cover showed an empty uterus. The abdominal cavity was washed and closed. She was transfused three units of red blood cell concentrate and had a normal six weeks follow-up.
CONCLUSION
When an instrument inserted into the uterus is pushed beyond the estimated depth of the uterus, a perforation must be suspected and the condition may be managed conservatively. A surgical procedure complicated by surgeon's loss of perception (in this case tactile) of tissues' anatomy is hazardous.
Topics: Abortion, Incomplete; Delivery of Health Care; Female; Humans; Uterine Hemorrhage; Uterine Perforation; Vacuum Curettage
PubMed: 36032497
DOI: 10.4314/ahs.v22i1.23 -
European Journal of Obstetrics,... Dec 2011Secondary postpartum haemorrhage (SPPH) is an important post-natal issue, whose significance is perceived differently between practices, settings and probably within... (Review)
Review
Secondary postpartum haemorrhage (SPPH) is an important post-natal issue, whose significance is perceived differently between practices, settings and probably within cultures. It is generally less focussed upon, in contrast to its primary counterpart. Patients prefer that it is treated promptly, even when it is not life-threatening. Intensity of blood loss, and the lesser popularity of conservative management drive clinicians towards the active options. Remarkably, none of the current treatment options is based on any evidence. Suction evacuation of the uterus may be complicated by life-threatening complications and blood transfusion. There are a few guidelines, and probably no protocols. In this review, we highlight salient factors to take into consideration, and propose a locally adaptable flowchart, which may be of use to General Practice doctors, Community Midwives and Obstetricians.
Topics: Decision Trees; Evidence-Based Medicine; Female; Humans; Postpartum Hemorrhage; Recurrence; Severity of Illness Index; Vacuum Curettage
PubMed: 21839573
DOI: 10.1016/j.ejogrb.2011.07.029 -
Contraception Jun 2018The objective was to describe factors associated with reported pain and assess correlations between participant and provider pain assessments during first-trimester...
OBJECTIVE
The objective was to describe factors associated with reported pain and assess correlations between participant and provider pain assessments during first-trimester vacuum aspiration.
STUDY DESIGN
Participants and providers in a trial evaluating music for pain reduction reported procedure-related pain using a 100-mm visual analog scale.
RESULTS
The mean participant-reported maximum pain was 65.9±23.0 compared to 41.3±22.0 by provider assessment. Provider-reported scores correlated poorly with participant maximum pain (r=0.28) and participant maximum pain adjusted for baseline (r=0.27). Previous abortion (60.5 versus 71.4, p=.02) and immediate intrauterine device insertion (46.1 versus 68.6, p=.03) were associated with lower participant-reported pain.
CONCLUSIONS
Providers underestimate pain reported during vacuum aspiration; provider estimates correlate poorly with participant self-report.
IMPLICATIONS
To improve management of pain during first-trimester vacuum aspiration, we need to better understand factors that influence patient and provider pain rating. When assessing patient pain in this setting, providers should not assume a baseline of zero pain.
Topics: Abortion, Induced; Adolescent; Adult; Female; Humans; Pain Measurement; Patients; Physicians; Pregnancy; Pregnancy Trimester, First; Vacuum Curettage; Young Adult
PubMed: 29317229
DOI: 10.1016/j.contraception.2018.01.001 -
Obstetrics and Gynecology Jul 2018
Topics: Abortion, Induced; Female; Humans; Hydatidiform Mole; Pregnancy; Vacuum Curettage
PubMed: 29939921
DOI: 10.1097/AOG.0000000000002719 -
BJOG : An International Journal of... Aug 2009Manual vacuum aspiration (MVA) is an alternative to the standard surgical curettage, performed under local anaesthetic in the setting of a treatment room. The aim of our...
Manual vacuum aspiration (MVA) is an alternative to the standard surgical curettage, performed under local anaesthetic in the setting of a treatment room. The aim of our study was to assess the efficacy of MVA in the management of first trimester early fetal demise and first- and mid-trimester incomplete miscarriage. This was a retrospective study of 246 patients who were scheduled to undergo MVA for first trimester early fetal demise and first- and mid-trimester incomplete miscarriage. One woman was excluded in the analysis because of the procedure being abandoned prior to MVA. Efficacy of the procedure was 94.7% (232/245). Incomplete uterine evacuation was seen in 5.3% (13/245) patients. Although not widely used in the UK, MVA could be considered routinely, thus avoiding general anaesthesia and the need for access to theatre.
Topics: Abortion, Incomplete; Adult; Female; Humans; Length of Stay; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Retrospective Studies; Vacuum Curettage
PubMed: 19459859
DOI: 10.1111/j.1471-0528.2009.02223.x -
International Journal of Gynaecology... Aug 2011
Topics: Abortion, Induced; Female; Humans; Pregnancy; Vacuum Curettage
PubMed: 21679947
DOI: 10.1016/j.ijgo.2011.03.007