Comparison of Manual Vacuum Aspiration With Dilatation and Evacuation

Abstract

ABSTRACT

Objective •

To compare the efficacy of manual vacuum aspiration with dilatation and evacuation for the management of miscarriages.

Study design

Comparative study.

Place & Duration of study

Department of Obstetrics and Gynecology Jinnah Postgraduate Medical Centre Karachi, From September 2018 to March 2019.

 Methodology

Patients were enrolled in the study after informed consent. Patients were divided into two groups A and B, randomly by lottery methods. Patients in group A underwent manual vacuum aspiration (MVA) and in group B dilatation and evacuation. Dilatation and evacuation was done in the operation theatre under general anesthesia and MVA was carried out in the examination room under paracervical block with Ipas® MVA system which consisted of an aspirator and cannula. Patients with missed abortion and closed cervical os were asked to take 400mcg of misoprostol sublingually two hours before coming to the hospital and 400mg of ibuprofen was given to the patients orally half an hour before MVA. All the data was collected and analyzed using SPSS 21.

 Results

• A total of 184 patients were enrolled. Mean of age of the patients in group A was 28.4 ± 6.5 year and in group B 28.1 ± 6.2 year. Mean gestational age in group A was 8.5 ± 3.1 week and in group B 8.2 ± 3.4 week. Efficacy was found 95.6% in group A versus 85.8% in group B and was statistically significant (P=0.022).

 Conclusion

Manual vacuum aspiration was a more effective method than dilatation and evacuation in first trimester miscarriages with additional advantage of being safe.