(Redirected from Manual vacuum aspiration)
- Manual Vacuum Aspiration Procedure Steps
- Manual Vacuum Aspiration Pdf
- Manual Vacuum Aspiration Steps For Children
- Manual Vacuum Aspiration Video
- MANUAL VACUUM ASPIRATION PROCEDURE I. The Procedure In many cases, women will be coming in first for options counseling and they will be making a decision during this visit about whether they elect to undergo a medication abortion or a suction procedure. This Policy and Procedure statement applies to the.
- Vacuum aspiration is an outpatient procedure that generally involves a clinic visit of several hours. The procedure itself typically takes less than 15 minutes. Suction is created with either an electric pump (electric vacuum aspiration or EVA) or a manual pump (manual vacuum aspiration or MVA). A hand-held 25cc or 50cc syringe can function as a manual pump.
1 INTRODUCTION. Vacuum aspiration is a very safe procedure for uterine evacuation, with major complications requiring intervention (such as hemorrhage requiring transfusion or perforation necessitating repair) occurring in up to 0.1% of procedures. 1 Ipas, a global non‐profit that works to improve sexual and reproductive rights, is the original developer of the manual vacuum aspirator (MVA.
Background | |
Abortion type | Surgical |
First use | China 1958 and UK 1967[1] |
Gestation | 3-12 weeks |
Usage | |
Figures are combined usage of MVA and EVA. | |
Sweden | 42.7% (2005) |
UK: Eng. & Wales | 64% (2006) |
United States | 88.3% (2003) |
Infobox references |
Vacuum or suction aspiration uses aspiration to remove uterine contents through the cervix. It may be used as a method of induced abortion, a therapeutic procedure used after miscarriage, or a procedure to obtain a sample for endometrial biopsy. The rate of infection is lower than any other surgical abortion procedure at 0.5%.[2]
Some sources may use the terms dilation and evacuation[3] or 'suction' dilation and curettage[4] to refer to vacuum aspiration, although those terms are normally used to refer to distinct procedures.
History[edit]
Vacuuming as a means of removing the uterine contents, rather than the previous use of a hard metal curette, was pioneered in 1958 by Drs Wu Yuantai and Wu Xianzhen in China,[5] but their paper was only translated into English on the fiftieth anniversary of the study that 'ultimately led to the technique becoming the world’s most common and safest obstetric procedure'.[1]
In Canada, the method was pioneered and improved on by Henry Morgentaler, achieving a complication rate of 0.48% and no deaths in over 5,000 cases.[6] He was the first doctor in North America to use the technique, which he trained other doctors to use.[7]
Dorothea Kerslake introduced the method into the United Kingdom in 1967 and published a study in the United States that further spread the technique.[1][8]
Harvey Karman in the United States refined the technique in the early 1970s with the development of the Karman cannula, a soft, flexible cannula that avoided the need for initial cervical dilatation and so reduced the risks of puncturing the uterus.[1]
Clinical uses[edit]
Vacuum aspiration may be used as a method of induced abortion, as a therapeutic procedure after miscarriage, to aid in menstrual regulation, and to obtain a sample for endometrial biopsy.[9] It is also used to terminate molar pregnancy.[10]
When used as a miscarriage treatment or an abortion method, vacuum aspiration may be used alone or with cervical dilation anytime in the first trimester (up to 12 weeks gestational age). For more advanced pregnancies, vacuum aspiration may be used as one step in a dilation and evacuation procedure.[11] Vacuum aspiration is the procedure used for almost all first-trimester abortions in many countries.[9]
Procedure[edit]
A diagram of a vacuum aspiration abortion procedure at 8 weeks gestation.
1: Amniotic sac
2: Embryo
3: Uterine lining
4: Speculum
5: Vacurette
6: Attached to a suction pump
Figure I is before aspiration of amniotic sac and embryo, and Figure II is after aspiration with the instrument still inside the uterus.
1: Amniotic sac
2: Embryo
3: Uterine lining
4: Speculum
5: Vacurette
6: Attached to a suction pump
Figure I is before aspiration of amniotic sac and embryo, and Figure II is after aspiration with the instrument still inside the uterus.
Vacuum aspiration is an outpatient procedure that generally involves a clinic visit of several hours.[12] The procedure itself typically takes less than 15 minutes.[2]Suction is created with either an electric pump (electric vacuum aspiration or EVA) or a manual pump (manual vacuum aspiration or MVA). A hand-held 25cc or 50cc syringe can function as a manual pump.[13] Both methods use the same level of suction, and so can be considered equivalent in terms of effectiveness and safety.[14]
The clinician may first use a local anesthetic to numb the cervix. Then, the clinician may use instruments called 'dilators' to open the cervix, or sometimes medically induce dilation with drugs. Finally, a sterile cannula is inserted into the uterus and attached via tubing to the pump. The pump creates a vacuum which empties uterine contents.[2]
After a procedure for abortion or miscarriage treatment, the tissue removed from the uterus is examined for completeness.[2] Expected contents include the embryo or fetus, as well as the decidua, chorionic villi, amniotic fluid, amniotic membrane and other tissue.
Post-treatment care includes brief observation in a recovery area and a follow-up appointment approximately two weeks later. These would tend to include tests for infection in case any biological material was not properly removed.
Manual Vacuum Aspiration Procedure Steps
Additional medications used in vacuum aspiration include NSAID analgesics that may be started already the day before the procedure, as well as misoprostol the day before for cervical ripening.[15]
Advantages over dilation and curettage[edit]
Dilation and curettage (D&C), also known as sharp curettage, was once the standard of care in situations requiring uterine evacuation. However, vacuum aspiration has a number of advantages over D&C and has largely replaced D&C in many settings.[16]
Vacuum aspiration may be used earlier in pregnancy than dilation and curettage (D&C). Manual vacuum aspiration is the only surgical abortion procedure available earlier than the 6th week of pregnancy.[2] Vacuum aspiration has lower rates of complications when compared to D&C.[14]
Vacuum aspiration - especially manual vacuum aspiration - is significantly cheaper than D&C. The equipment needed for vacuum aspiration costs less than a curette set. While D&C is generally provided only by physicians, vacuum aspiration may be performed by advanced practice clinicians such as physician assistants and midwives.[17]
Manual vacuum aspiration does not require electricity and so can be provided in locations that have unreliable electrical service or none at all. Manual vacuum aspiration also has the advantage of being quiet, without the noise of an electric vacuum pump.[17] Download circle sidebar pro apk.
Complications[edit]
When used for uterine evacuation, vacuum aspiration is 98% effective in removing all uterine contents.[14] Retained products of conception require a second aspiration procedure. This is more common when the procedure is performed very early in pregnancy, before 6 weeks gestational age.[2]
Other complications occur at a rate of less than 1 per 100 procedures and include excessive blood loss, infection, injury to the cervix or uterus,[14] including perforation, and uterine adhesions.[18]
References[edit]
- ^ abcdCoombes R (14 June 2008). 'Obstetricians seek recognition for Chinese pioneers of safe abortion'. BMJ. BMJ. 336 (7657): 1332–3. doi:10.1136/bmj.39608.391030.DB. PMC2427078. PMID18556303. Archived from the original on 16 June 2008.
- ^ abcdef'Manual and vacuum aspiration for abortion'. A-Z Health Guide from WebMD. October 2006. Archived from the original on October 28, 2008. Retrieved February 18, 2006.
- ^'Miscarriage'. EBSCO Publishing Health Library. Brigham and Women's Hospital. January 2007. Archived from the original on 2007-09-27. Retrieved 2007-04-07.
- ^'What Every Pregnant Woman Needs to Know About Pregnancy Loss and Neonatal Death'. The Unofficial Guide to Having a Baby. WebMD. 2004-10-07. Archived from the original on 2007-10-21. Retrieved 2007-04-29.
- ^Wu Y, Wu X (1958). 'A report of 300 cases using vacuum aspiration for the termination of pregnancy'. Chinese Journal of Obstetrics and Gynaecology. 336 (7657): 447–9. doi:10.1136/bmj.39608.391030.DB. PMC2427078. PMID18556303.
- ^Morgentaler H H (1973). 'Report on 5641 outpatient abortions by vacuum suction curettage'. CMAJ. 109 (12): 1202–5. PMC1947080. PMID4758593. Archived from the original on 2015-10-18.
- ^Morgentaler H (May–Jun 1989). 'Alan F. Guttmacher lecture'. Am J Gynecol Health. 3 (3–S): 38–45. PMID12284999.
- ^Kerslake D, Casey D (July 1967). 'Abortion induced by means of the uterine aspirator'. Obstet Gynecol. 30 (1): 35–45. PMID5338708.
- ^ abBaird, Traci L.; Susan K. Flinn (2001). 'Manual Vacuum Aspiration: Expanding women's access to safe abortions services'(PDF). --. Ipas: 3. Archived from the original(PDF) on 2008-02-27. Retrieved 2008-01-28.CS1 maint: extra punctuation (link), which cites:
- Greenslade, Forrest; Janie Benson; Judith Winkler; Victoria Henderson; Ann Leonard (1993). 'Summary of clinical and programmatic experience with manual vacuum aspiration'. Advances in Abortion Care. 3 (2).
- ^'Managing complications in pregnancy and childbirth: A guide for doctors and midwives'. World Health Organization. 2003. Archived from the original on 2006-09-09. Retrieved 2006-09-14.
- ^Baird (2001), pp. 4-5,14 (sidebars and information box).
- ^Baird (2001), p. 10 (table).
- ^'All About the Machine Vacuum Aspiration Procedure for Early Abortion'. about.com. Archived from the original on 4 March 2016. Retrieved 3 May 2018.
- ^ abcdBaird (2001), pp. 4-6.
- ^Table 2 in: Allison JL, Sherwood RS, Schust DJ (2011). 'Management of first trimester pregnancy loss can be safely moved into the office'. Rev Obstet Gynecol. 4 (1): 5–14. PMC3100102. PMID21629493.
- ^Baird (2001), p. 2.
- ^ abBaird (2001), pp. 5,8-13.
- ^Dalton, VK; Saunders NA; Harris LH; Williams JA; Lebovic DI (June 2006). 'Intrauterine adhesions after manual vacuum aspiration for early pregnancy failure'. Fertility and Sterility. 85 (6): 1823.e1–3. doi:10.1016/j.fertnstert.2005.11.065. PMID16674955.
Retrieved from 'https://en.wikipedia.org/w/index.php?title=Vacuum_aspiration&oldid=916580766'
In This Article
Table of Contents
- What to Expect
- Recovery
- Effectiveness
Manual Vacuum Aspiration Pdf
The early abortion machine vacuum aspiration procedure is one of three available options to end an early pregnancy (the abortion pill and manual aspiration are the other methods). This early abortion method can be used 5 to 12 weeks after your last menstrual period.
![Vacuum Vacuum](/uploads/1/2/6/4/126483020/502350863.jpg)
This procedure is quick (5 to 15 minutes) and can be safely completed in a regular medical office or clinic.
Machine Vacuum Aspiration Also Known As
- Early abortion
- Aspiration abortion
- Machine vacuum aspiration
- Vacuum aspiration
Before the Procedure
- An osmotic (cervical) dilator may be inserted into the cervix to slowly dilate its opening either a day before or hours before a machine vacuum aspiration abortion.
- Misoprostol may be given to help soften the cervix.
- Pain or sedation medication might be provided orally or intravenously. Vasopressin (or a comparable medication) could also be mixed with the local anesthetic to lessen or slow bleeding at the injection site on the cervix.
During the Procedure
- Your doctor will insert a speculum.
- The cervix will be cleaned with antiseptic and numbed with a local anesthetic.
- The uterus is held in place with an instrument that grasps the cervix. The cervix is then dilated to reduce the risk of injury to it.
- A hollow tube, called a cannula, is inserted into the cervix. It is attached by tubing to a bottle and a pump.
- When the pump is turned on, it creates a gentle vacuum that suctions the tissue out of the uterus.
During this time, you may feel mild to moderate cramping because of your uterus contracts when the tissue is removed. There is some discomfort, yet the cramping should lessen once the cannula is taken out. You also might feel faint, sweaty or nauseous.
After the Aspiration Abortion
- After a machine vacuum aspiration abortion, the removed tissue may be examined to make sure that all of it has been taken out, and the abortion is complete.
- Based on how you are feeling, you can usually resume normal activities the next day. You will probably need to wait about a week for sexual activity or to use tampons.
Possible Side Effects
- After the procedure, you will most likely be bleeding, though there tends to be less bleeding after the aspiration procedure than with the use of the abortion pill. (The bleeding is lighter than a typical period). You could also have some spotting for the first two weeks.
- You may be prescribed antibiotics to prevent infection.
- You could also experience more cramps that may occur for a few hours (after the aspiration procedure) to maybe even a few days (as your uterus is shrinking back to its normal size). Your doctor may suggest acetaminophen or ibuprofen relieve this cramping.
Effectiveness
Manual Vacuum Aspiration Steps For Children
The aspiration procedure is approximately 98-99% effective. Yet, in rare cases, an aspiration procedure may not end a pregnancy. This is more likely to occur in manual aspirations performed before 6 weeks, where about 3% fail and require a repeat procedure.
If all of the tissue has not been successfully removed during a machine vacuum aspiration, a dilation and curettage (D&C) proceduremight be needed.
Final Thoughts
- Machine vacuum aspiration abortion is safe for future pregnancy, as there is the minimal possibility of developing scar tissue.
- This procedure is typically safe, effective and has a low risk for complications.
- Minor complications that could occur include injury to the uterine lining or cervix or infection.
Manual Vacuum Aspiration Video
- Keder LM. 'Best practices in surgical abortion.'Journal of Obstetrics and Gynecology 2003 189:418–422.