MANUAL VACUUM ASPIRATION (MVA): A SAFER AND MORE EFFICIENT ALTERNATIVE TO CONVENTIONAL CURETTAGE IN FIRST TRIMESTER MISCARRIAGE

Abstract

Spontaneous abortion, sometimes referred to as miscarriage, is a prevalent complication of early pregnancy that predominantly occurs during the first trimester of pregnancy. The annual miscarriage rate in Pakistan for women aged 15–49 years is estimated at 29 per 1,000. Conventional surgical therapy typically depends on dilatation and curettage (D&C); however, this technique is associated with significant risks. Manual vacuum aspiration (MVA) has emerged as a less invasive alternative, offering potential benefits in terms of safety, effectiveness, and resource efficiency. To evaluate the effectiveness and safety of MVA compared to conventional curettage in the surgical treatment of first-trimester miscarriages. A randomized controlled experiment was performed at the Department of Gynecology and Obstetrics, Bolan Medical Complex, Quetta. A total of 274 women aged 18–35 years who experienced first-trimester miscarriages were randomly assigned to two groups: Group A (MVA) and Group B (traditional curettage). Efficacy was defined as the complete evacuation of uterine contents, verified by transvaginal ultrasonography, indicating an endometrial thickness of less than 4 mm with no retained products. MVA achieved a total evacuation rate of 95.6%, compared to 85.8% in the conventional curettage. MVA was correlated with reduced procedure length, decreased blood loss, and a shorter hospital stay. MVA is a secure and efficient substitute for traditional curettage in the treatment of first-trimester miscarriages. Clinical benefits, including reduced complications and enhanced efficiency, support the broader implementation of MVA in standard practice to improve patient outcomes and optimize healthcare resources.