MANUAL VACUUM ASPIRATION (MVA): A SAFER AND MORE EFFICIENT ALTERNATIVE TO CONVENTIONAL CURETTAGE IN FIRST TRIMESTER MISCARRIAGE

Abstract

Background: Miscarriage, also known as spontaneous abortion, is a common issue during early pregnancy. In Pakistan, the miscarriage rate is about 29 per 1,000 women aged 15 to 49 years. Dilation and curettage (D&C) is a common surgical procedure, which is effective but can also be risky.

Objective: This study aimed to compare the safety and effectiveness of Manual Vacuum Aspiration (MVA) with traditional curettage in managing first-trimester miscarriages.

Material and Methods: A randomized trial was carried out at the Department of Gynecology and obstetrics, Bolan Medical complex, Quetta. The study included 274 women aged 18-35 who had miscarriages during the first trimester and were randomly divided into two groups of equal numbers: Group A receiving MVA and Group B Undergoing D& C.

Results: MVA achieved full evacuation in 113 (95.6 %) and D&C in 117(85.8 %) (significant difference, p 0.05). The MVA procedure took an average of 6.9 minutes, about half as much as 13.7 minutes per D&C. Only 0.6% of MVA patients had serious bleeding (>= 100mL) as compared to 2.4% in the D&C group. In both groups, no uterine perforations or serious infections were noted.

Conclusion: MVA is a safe, effective and efficient alternative to traditional curettage of first-trimester miscarriages. It has a greater success rate, less procedure time, less risk of complications and improved patient satisfaction, which is evidence to expand the use of MVA in everyday gynecological practice.