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Manual Vacuum Aspiration General/Patient Information

The majority of the following information was made public by the Access Project.

Q: What abortion methods are used in the first trimester?

A. 1. Sharp curettage uses mechanical dilators to open the cervix and metal instruments called curettes to scrape the sides of the uterus. This procedure is also referred to as: dilatation or dilation and curettage (D&C) and surgical abortion. It often requires heavy sedation or general anesthesia and, because of increased risk of complications, should only be used when neither vacuum aspiration nor medication abortion is available.

2. Vacuum aspiration removes the uterine contents by applying suction through a cannula that has been inserted through the cervix into the uterus. Other terms for vacuum aspiration include: suction abortion, vacuum curettage, suction curettage, menstrual regulation (MR) and mini-suction. According to the World Health Organization, vacuum aspiration is typically used through 12 or 15 weeks, depending upon instruments available and provider training and skills. Vacuum aspiration can be subdivided into two types:

Electric vacuum aspiration (EVA) uses suction from an electric pump. Cannulae used with EVA may be made of plastic or metal.

Manual vacuum aspiration (MVA) uses a non-electric aspirator. Most instruments used for MVA are handheld aspirators. Plastic cannulae, which vary from rigid to very flexible, are used with MVA aspirators.

Both EVA and MVA are extremely safe and effective. A recent study by Goldberg et al, entitled “Manual versus electric vacuum aspiration for early first-trimester abortion: a controlled study of complication rates”, confirmed that there is no significant difference in the rate of complications between these methods.

Q. What is MVA?

A. The manual vacuum aspirator is a hand-operated 60 mL syringe in which vacuum is produced by sealing one end of the syringe and retracting a plunger at the other. The syringe is attached to a flexible cannula for uterine aspiration. The MVA is portable, inexpensive and quite. The equipment can be used to preform endometrial sampling in non-pregnant women, completion or treatment of post-abortion complications, and for elective early-term abortion.

Q. What is MVA used for?

A. It can be used safely and effectively for early abortion, menstrual extraction and completing incomplete abortions.

Q. How far along in the pregnancy can the procedure be performed?

A. First trimester through 12 weeks with a 98-99% success rate. Nonsuccessful treatments require a second treatment during the same or subsequent visits.

Q. How long does the procedure take?

A. The procedure takes 5-10 minutes total although there is pre and post work up. A follow up visit with the health care provider is suggested.

Q. Is it scary?

A. MVA is performed in the primary care setting. The procedure is often silent such that it is difficult to judge when the aspiration has actually begun.

Q. How painful is it?

A. Mild to very strong cramping occurs during the procedure. Pain medication during and after the procedure can help alleviate this.

Q. How much bleeding will occur?

A. Usually there is light bleeding for the first 1-7 days, although it can continue up to 2 weeks.

Q. Can the abortion fail?

A. The MVA procedure has a 98% success rates. In 2% of the cases, the procedure needs to be repeated and is then successful.

Q. Is it safe?

A. MVA has been studied for over 30 years and is standard practice in US clinics and hospitals. When conducted within the first 12 weeks, it has a 1% complication rate and is 10 time safer than childbirth.

Q. What are the advantages of MVA?

A. It is quick, safe and successful. There is less bleeding than regular medical abortions.

Q. What are the disadvantages?

A. The procedure is more invasive that chemical approaches (abortion pills). The anesthetics and drugs administered to manage pain during the procedure may cause side effects. In 1% of cases, complications can include uterine perforation, cervical injury, hospitalization, and late complications of pelvic infection and retained products of conception.

 

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