A comparative study between manual vacuum aspiration and electrical vacuum aspiration for the first trimester medical termination of pregnancy

Sunil K. Samal, Setu Rathod, Maya Padhi

Abstract


Background: The aim of this study is to compare the manual vacuum aspiration (MVA) and electrical vacuum aspiration (EVA) as the method for first trimester medical termination of pregnancy (MTP) in terms of efficacy, blood loss, duration, acceptability and complications. The study also compares paracervical block (PCB) and intramuscular sedation (IMS) i.e., injection pentazocine 30 mg and injection promethazine 25 mg as pre-operative analgesia for both the MTP procedures.

Methods: The present study was conducted in the postpartum center and department of Gynecology and Obstetrics, SCB Medical College, Cuttack. A total 200 patients were studied of which randomly selected 100 patients underwent MVA and remaining 100 patients underwent EVA. Cases were compared with respect to their age, parity, blood loss, time taken and complications.

Results: In the present study, MVA was effective in 97% and EVA in 98% cases. Thus, the two procedures did not show much difference as far as their effectiveness was concerned. Comparing intra and post-operative pain, PCB was significantly more effective in reducing pain as compared to IMS.

Conclusions: MVA has a safety and efficacy profile similar to that of EVA. Furthermore, MVA is a simple, safe, effective procedure, portable and low cost technique. Hence, MVA is a promising method compared to EVA and can be practiced widely in rural areas where access to medical facilities are limited, high-tech equipments were not available and the power supply was erratic and maintenance of instruments were not up to the mark. The judicious use of MVA comes with a promise to make early abortions safe and easily accessible to women of both rural and urban societies belonging to any socio-economic strata.


Keywords


Manual vacuum aspiration, Electrical vacuum aspiration, Abortion, Paracervical block

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References


Banerjeea SK, Andersenb KL, Warvadekara J. Pathways and consequences of unsafe abortion: A comparison among women with complications after induced and spontaneous abortions in Madhya Pradesh, India. Int J Gynecol Obstet. 2012;118(Suppl 2):S113-20.

WHO. The Prevention and Management of Unsafe Abortion. Report of a Technical Working Group. Geneva. WHO, 1992. Available at: whqlibdoc.who.int/hq/1992/WHO_MSM_92.5.pdf‎.

WHO. Unsafe Abortion: Global and Regional Estimates of the Incidence of Unsafe Abortion and Associated Mortality in 2003. 5th ed. Geneva: WHO; 2007.

WHO. Safe Abortion: Technical and Policy Guidance for Health Systems. 5th ed. Geneva: WHO; 2003: 106.

Kamel H, Sebanti G, Rekha D. Manual vacuum aspiration and electrical vacuum aspiration - A comparative study for first trimester MTP. J Obstet Gynecol India. 2011;61:53-6.

Westfall JM, Sophocles A, Burggraf H, Ellis S. Manual vacuum aspiration for first-trimester abortion. Arch Fam Med. 1998;7:559-62.

Wen J, Cai QY, Deng F, Lia YP. Manual versus electric vacuum aspiration for first-trimester abortion: A systematic review. BJOG. 2007;115:5-13.

Nasira T, Mahmud G, Fatima S, Sultana M. Manual vacuum aspiration: a safe and cost-effective substitute of Electric vacuum aspiration for the surgical management of early pregnancy loss. J Pak Med Assoc. 2011;61:149-53.

Goldberg AB, Dean G, Kang MS, Youssof S, Darney PD. Manual versus electric vacuum aspiration for early first-trimester abortion: A controlled study of complication rates. Obstet Gynecol. 2004;103:101-7.

Dean G, Cardenas L, Darney P, Goldberg A. Acceptability of manual versus electric aspiration for first trimester abortion: A randomized trial. Contraception. 2003;67:201-6.

Milingos DS, Mathur M, Smith NC, Ashok PW. Manual vacuum aspiration: A safe alternative for the surgical management of early pregnancy loss. BJOG. 2009;116:1268-71.

Tekle GE, Ruminjo JK, Sekadde-Kigondu C. Pain relief using paracervical block with 1% lignocaine injection in patients undergoing uterine evacuation by manual vacuum aspiration of uterus. East Afr Med J. 2002;79:530-4.