A comparison of manual vacuum aspiration (MVA) and sharp curettage in the management of incomplete abortion

Mahomed, Kassam; Healy, Joan; Tandon, Shruti

doi:10.1016/0020-7292(94)90305-0

Cited by 24 publications

(22 citation statements)

References 5 publications

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“…2 Manual vacuum aspiration (MVA) involves the use of a hand-held syringe as a source of suction during uterine evacuation. 3 It has been used for many years, mainly in developing countries and areas with limited medical resources, although in recent years there has been increasing experience in the USA of surgical abortion using MVA under local anaesthesia. Edward and Creinin reported a series of 2399 cases of early surgical abortion using MVA.…”

Section: Introductionmentioning

confidence: 99%

Surgical abortion using manual vacuum aspiration under local anaesthesia: a pilot study of feasibility and women's acceptability

Hamoda

Flett

Ashok

et al. 2005

j fam plann reprod health care

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Objective Studies from the USA have reported the efficacy and high acceptability of surgical abortion using manual vacuum aspiration (MVA) under local anaesthesia. The aim of this study was to assess the feasibility, acceptability and efficacy of surgical abortion using MVA under local anaesthesia for termination of pregnancy up to 63 days' gestation, within a UK National Health Service setting. Methods Surgical abortion was carried out using MVA under local anaesthesia. Women's satisfaction with the procedure, and pain and anxiety levels, were assessed. The main outcome measures were: (1) feasibility assessed through successful completion of the procedure without the need for general anaesthetic or conversion to suction vacuum aspiration, (2) efficacy assessed through complete uterine evacuation without the need for further medical or surgical intervention and (3) women's acceptability of the procedure. Results The mean (SD) gestation was 50 (9.4) days. A total of 55/56 (98%) women had a successful procedure and did not require any further surgical or medical treatment. Fifty-five (98%) women were satisfied with the procedure, 48 (86%) said they would recommend it to a friend and 45 (80%) said they would have the same method again in the future. Anxiety levels, as reflected by the visual analogue scales, showed a significant fall in anxiety scores following the procedure (p<0.01). Conclusions Surgical abortion using MVA under local anaesthesia is effective and acceptable to women. These findings now need to be assessed in the context of a randomised trial. Key message points q Surgical abortion using manual vacuum aspiration under local anaesthesia appears to be feasible and acceptable to women.q The procedure can be performed on an outpatient basis thus reducing the cost and burden on day surgery lists. This may have implications for health service provision.q These findings, as well as the cost implications of this approach, now need to be assessed in the context of a randomised trial.

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Section: Introductionmentioning

confidence: 99%

Surgical abortion using manual vacuum aspiration under local anaesthesia: a pilot study of feasibility and women's acceptability

Hamoda

Flett

Ashok

et al. 2005

j fam plann reprod health care

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show abstract

“…Manual vacuum aspiration (MVA) has been introduced as an alternative method to manage first‐trimester pregnancy loss 1 and incomplete abortion 3,10,11 as well as SC. MVA has a high efficacy when it is used for the treatment of incomplete abortion 3,8 . Evidence from a retrospective study showed that MVA might be slightly more effective than SC 8 .…”

Section: Discussionmentioning

confidence: 99%

“…The condition should be managed with suitable methods in the proper time. The management for incomplete abortion includes medical 3–6 and surgical methods 1,3,7–9 . Each modality has its advantages and disadvantages.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of efficacy of modified electric vacuum aspiration with sharp curettage for the treatment of incomplete abortion: Randomized controlled trial

Kittiwatanakul

Weerakiet

2012

J of Obstet and Gynaecol

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“…A workshop on manual vacuum aspiration for management of first trimester pregnancy loss may be particularly useful. 9 Because electronic fetal monitoring is not universally available in devel-oping countries, intermittent auscultation skills should be emphasized. Another common issue in developing countries is the lack of access to cesarean section capabilities.…”

Section: Lessons Learned For Future International Also Coursesmentioning

confidence: 99%

Advanced Life Support in Obstetrics in Ecuador: Teaching the Teachers

Dresang¹,

Rodney²,

Leeman³

et al. 2004

The Journal of the American Board of Family Medicine

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The advanced life support in obstetrics (ALSO) course is designed to help maternity care providers prepare for obstetrical emergencies. A team of 12 US physicians and a medical interpreter recently taught the ALSO course in Ecuador, with the goal of addressing Ecuador's high maternal and infant mortality rates. To have a greater impact, a teach-the-teacher model was used so that Ecuadorian physicians can now hold their own ALSO courses. In the process of implementing the courses, valuable lessons were learned which can be applied to future ALSO courses in developing countries and in the United States. "Give someone a fish and you feed them for a day; teach someone to fish and you feed them for a lifetime." Following this proverbial advice, a teachthe-teacher model was used when 12 physicians and a medical interpreter went to Ecuador in February 2003 to teach the advanced life support in obstetrics (ALSO) course. This article describes why the ALSO course was chosen, how Ecuador was chosen, how the courses were implemented, and what lessons might be useful for organizers of future international and US ALSO courses. Why the ALSO Course?In 1991, the ALSO course was developed by 2 Wisconsin family physicians, James Damos and John Beasley.1-3 The course was obtained by the American Academy of Family Physicians (AAFP) in 1993. The curriculum focuses on the management of obstetrical emergencies and is modeled after the advanced cardiac life support (ACLS) and advanced trauma life support (ATLS) courses. Now in its fourth edition, the ALSO course is evidence-based, categorizing its recommendations according to the strength of supporting evidence. The course uses an adult-learning model, emphasizing interactive workshops and hands-on learning through the use of mannequins, and the course lends itself well to a teach-the-teacher model, whereby students are trained to become future instructors.The ALSO course has been taught outside of the United States since 1995. In Latin America and the Caribbean, courses have been taught in Haiti and Paraguay. To date, more than 30,000 providers have take the ALSO course in the United States and 12,239 have taken the course internationally. The United States has 987 approved instructors and 238 advisory faculty, compared with 900 international approved instructors.Instead of teaching 1 course and then leaving, we wanted to increase our impact by teaching Ecuadorian physicians to put on their own courses. After discussing how we chose Ecuador, we discuss use of a teach-the-teacher model with the Ecuador ALSO courses. Why Ecuador?The decision to teach the ALSO courses in Ecuador was based on its location in Latin America, its high maternal and infant mortality rates, the presence of a family medicine residency, and personal connections with Ecuadorian faculty members.We speak Spanish and we wanted to introduce the ALSO course to Spanish-speaking Latin America. In preparation for the Ecuador courses, the

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A comparison of manual vacuum aspiration (MVA) and sharp curettage in the management of incomplete abortion

Abstract: Given the safety and effectiveness of the MVA procedure and the potential for reducing health care costs and improving patient management, this technology should be considered by health care systems in developing countries for improving treatment of abortion complications.

Cited by 24 publications

References 5 publications

Surgical abortion using manual vacuum aspiration under local anaesthesia: a pilot study of feasibility and women's acceptability

Surgical abortion using manual vacuum aspiration under local anaesthesia: a pilot study of feasibility and women's acceptability

Comparison of efficacy of modified electric vacuum aspiration with sharp curettage for the treatment of incomplete abortion: Randomized controlled trial

Advanced Life Support in Obstetrics in Ecuador: Teaching the Teachers

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