Manual Compared With Electric Vacuum Aspiration for Abortion at Less Than 6 Weeks of Gestation

Dean, Gillian; Colarossi, Lisa G.; Porsch, Lauren; Betancourt, Gabriela; Jacobs, Adam; Paul, Maureen

doi:10.1097/aog.0000000000000787

Cited by 10 publications

(5 citation statements)

References 9 publications

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“…Last, we also acknowledge the evidence basis for the safety of manual vacuum aspiration, which was temporarily not performed at our institution during this timeframe. Indeed, previous authors have demonstrated similarly low complication rates with MVA when compared to EVA [ 15 – 17 ], suggesting that inferences of the benefit of transvaginal ultrasonography in this population can be made as well.…”

Section: Discussionmentioning

confidence: 87%

The implementation of routine procedural transvaginal sonography to decrease retained products of conception: a quality improvement initiative

et al. 2021

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Background Retained products of conception (POC) following uterine evacuation can lead to adverse sequelae, including hemorrhage, endometritis, intrauterine adhesions, and reoperation. Use of procedural transvaginal sonography (TVUS) in the operating room has been proposed to help decrease retained POC. Methods A retrospective review of all first trimester uterine evacuation procedures from 1/2015 to 2/2017 was performed, noting use of transabdominal ultrasonography, retained products of conception, and complications. A practice change was implemented in May 2018, in which routine intra-procedural TVUS use was initiated. A second retrospective chart review was conducted to assess for post-implementation incidence of retained POC, re-operation, and associated complications. Results Prior to intra-procedural TVUS implementation, 130 eligible procedures were performed during the specified timeframe, with 9/130 (6.9%) incidence of retained products of conception. TAUS was performed in 59/130 (45.4%) of procedures, and 4/9 (44.4%) of those with retained products. There were eight re-operative procedures in seven patients, and two patients were treated with misoprostol. Complications included hemorrhage, Asherman’s syndrome and endometritis. Following implementation, 95 first trimester procedures were performed with transvaginal sonography, with 0 (0%) cases of retained POC (p = 0.01), no incidences of re-operation (p = 0.02), and one case of Asherman’s syndrome. TVUS findings led to additional focused suction curettage in 20/95 (21.0%) of procedures. The endometrium was measured on procedure completion in 64 procedures, with a mean thickness of 5.5 mm (1–12 mm). Conclusion Implementation of routine TVUS during uterine evacuation may reduce the incidence of retained POC and associated reoperation rates. Further multi-center trials are needed to confirm this finding.

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Section: Discussionmentioning

confidence: 87%

The implementation of routine procedural transvaginal sonography to decrease retained products of conception: a quality improvement initiative

et al. 2021

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“…A total of 114 RCTs were included in the review . The PRISMA flow chart in Figure S1 shows study selection.…”

Section: Resultsmentioning

confidence: 99%

Outcomes in prevention and management of miscarriage trials: a systematic review

Smith

Dhillon-Smith

O’Toole

et al. 2018

BJOG

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Background There is a substantial body of research evaluating ways to prevent and manage miscarriage, but all studies do not report on the same outcomes. Objective To review systematically, outcomes reported in existing miscarriage trials. Search strategy MEDLINE, Embase, CINAHL, and Cochrane were searched from inception until January 2017. Selection criteria Randomised controlled trials (RCTs) reporting prevention or management of miscarriage. Miscarriage was defined as a pregnancy loss in the first trimester. Data collection and analysis Data about the study characteristics, primary, and secondary outcomes were extracted. Main results We retrieved 1553 titles and abstracts, from which 208 RCTs were included. For prevention of miscarriage, the most commonly reported primary outcome was live birth and the top four reported outcomes were pregnancy loss/stillbirth (n = 112), gestation of birth (n = 68), birth dimensions (n = 65), and live birth (n = 49). For these four outcomes, 58 specific measures were used for evaluation. For management of miscarriage, the most commonly reported primary outcome was efficacy of treatment. The top four reported outcomes were bleeding (n = 186), efficacy of miscarriage treatment (n = 105), infection (n = 97), and quality of life (n = 90). For these outcomes, 130 specific measures were used for evaluation. Conclusions Our review found considerable variation in the reporting of primary and secondary outcomes along with the measures used to assess them. There is a need for standardised patient‐centred clinical outcomes through the development of a core outcome set; the work from this systematic review will form the foundation of the core outcome set for miscarriage. Tweetable abstract There is disparity in the reporting of outcomes and the measures used to assess them in miscarriage trials.

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“…In our case, we selected MVA for uterine drainage, but the choice of EVA is also available. MVA is more portable, less expensive, clean, quiet, does not require electricity 5 6. The plastic cannula used in MVA is less likely to damage the endometrial basal layer due to its adequate stiffness and high flexibility 6.…”

Section: Discussionmentioning

confidence: 99%

Manual vacuum aspiration for postpartum pyometra

Io,

Takemura,

Takemura

2023

BMJ Case Rep

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Postpartum pyometra is rare; however, it may lead to sepsis. The main initial symptoms are fever, lower abdominal pain and foul-smelling lochia. The treatment includes antibiotic administration and surgical drainage. This is a report of postpartum pyometra following a caesarean section that was successfully treated with manual vacuum aspiration, a simple and minimally invasive option. Other treatment options include pyometra reduction using placenta forceps and the placement of an intrauterine drainage catheter.

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Manual Compared With Electric Vacuum Aspiration for Abortion at Less Than 6 Weeks of Gestation

Abstract: I.

Cited by 10 publications

References 9 publications

The implementation of routine procedural transvaginal sonography to decrease retained products of conception: a quality improvement initiative

The implementation of routine procedural transvaginal sonography to decrease retained products of conception: a quality improvement initiative

Outcomes in prevention and management of miscarriage trials: a systematic review

Manual vacuum aspiration for postpartum pyometra

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