MVA; A Versatile Measure for the Management of 1st Trimester Incomplete Abortion, Endometrial Aspiration and Menstrual Regulation

Abstract

Background: Abortion may be defined as any interruption or interference in the continuation of pregnancy any time before 28 wks of pregnancy characterized by abdominal pain or per vaginal bleeding or both with or without expulsion of product of conception. Objectives: To find out the outcome of manual vacuum aspiration in the management of patients of incomplete abortion, menstrual regulation and endometrial aspiration. Materials & Methods: This observational prospective study was conducted in the department of Obstetrics & Gynaecology, Dinajpur Medical College Hospital and Reproductive Health Services Training and Education Programme (RHSTEP), Dinajpur from February to July 2017. One hundred cases of 1^st trimester incomplete, abortion, menstrual regulation & people coming with die complain of DUB, post menopausal bleeding, infertile women with specific drug therapy were managed by manual vacuum aspiration during this period. A data recording sheet was designed for this purpose. Haemodynamically stable patients were enrolled purposively according to inclusion and exclusion criteria. Results: Procedure time of manual vacuum aspiration was short and bleeding was minimum. During the procedure, no resuscitation was required in most of the cases (94%). Only 6% patients required fluid replacement and 3%, cases required blood transfusion that was severely anemic at the time of admission. Average duration of hospital stay was 2 hours. Complete recovery occurred in about 98% cases with very low post procedure complication rate. Conclusion: MVA procedure is a safe and effective technique  of uterine evacuation in incomplete abortion, menstrual regulation as well as endometrial aspiration. It is quick, less expensive, portable and less painful. Hospital stay and chance of perforation of uterus is less. So, it is a promising method and can be practiced widely in rural areas where access to medical facilities are limited, high-tech equipments are not available and maintenance of instruments are not up to the mark.