Abstract:
Objective: To compare the safety, efficacy and complications of manual vacuum aspiration (MVA ) versus surgical
evacuation in low resource set up.
Study Design and Setting: This crossectional study conducted at Department of Obstetrics & Gynaecology at Kulsoom
Bai Valika Social Security SITE Hospital Karachi from January to June 2017.
Methodology: A total of one hundred patients with less than 12 weeks of gestation and diagnosis of missed miscarriage,
incomplete miscarriage, blighted ovum or with retained products of conception (RPOCs) were recruited and randomly
allocated to MVA without anesthesia (Group A) and surgical evacuation under general Anesthesia in Operation theatre
(Group B).Both groups were compared in terms of demographic and obstetric data, clinical course (need of anaesthesia,
operating time, approximate blood loss and stay in hospital) ,complications(excessive bleeding, uterine perforation, need
for re-evacuation/ failed procedure, sepsis and maternal death ) and patient satisfaction.
Results: Mean age of patients was 28.68 in Group A and 26.90 in Group B ( P value-0.136). Average gestational age in
weeks at which procedure was performed in Group A found to be 8.32 and 9.546 for Group B ( P value-0.007 ). Parity
was comparable in both groups (P value-0.746). Most of the patients were literate. Mean operating time and amount of
blood loss comparison among groups had no statistical difference. Average hospital stay was significantly short in MVA
Group ( P value-0.001). No maternal death or uterine perforation observed in both the groups,6% and 8% of patients had
excessive bleeding in Group A & Group B respectively, one patient underwent re-evacuation in MVA group and one had
sepsis after surgical evacuation. Post procedure satisfaction was comparable in both the groups.