Effectiveness of manual vacuum aspiration (MVA) in the management of first trimester miscarriage: Experience in a specialist centre in North-Eastern Nigeria

Abstract

Background: Safe management of abortion with an easy, simple and effective procedure is mandatory to minimise abortion related morbidities and mortalities.

Aim: To assess the pattern of presentation of cases of first trimester miscarriage and the value of manual vacuum aspiration (MVA) in the management of abortion.

Methods: Clinical records of 251 cases of miscarriage managed over a 3-year period 2005 - 2007 using MVA ipas aspirator were retrieved and information pertaining to age parity, gestational age at presentation, indication for MVA use, duration of hospital stay and complications encountered were retrieved for analysis and interpretation.

Results: A total of 1899 gynaecological procedures were carried out over the 3-year period, out of which 251 were MVA procedures performed for various first trimester miscarriages, accounting for 13.2 % of the total gynaecological admissions. Sixty one (24.3%) of the patients who benefited from MVA were in the 25-29 years age group,  while those in the age 20-24 and 30-34 years group constituted 21.5% and 20.7% respectively. Grandmultiparas (53.7%) constituted the majority. The procedure was performed for 50.2% of the patients at 9-11 wks of gestation.  Most (88.0%) of the patients had the procedure performed for incomplete abortion and while the remaining 12.0% were for check MVA after complete abortion and missed abortion. Most (67%) of the cases were perform as outpatient procedures. There were three maternal deaths which were not related to the procedure.

Conclusions: First trimester miscarriage appeared to be most common among grandmultipara and during the 9-11weeks of gestation. Most of the patients fell into the 25-29 years age group. It appears MVA is being effectively utilized in our centre.

Key words: Manual vacuum aspiration, Miscarriage, Experience, North eastern Nigeria