Manual Vacuum Aspiration (MVA) versus Electric Vacuum Aspiration (EVA) in first trimester medical termination of pregnancy (MTP)

Background: Approximately 47000 pregnancy related deaths occur due to complication of unsafe abortion. To correct this Ministry of Health and Family Welfare had appointed the expert group for MTP Act and amend it to enable increased access to safe abortion services for all women. The WHOs preferred methods to safely and effectively terminate pregnancy during the first trimester of pregnancy are vacuum aspiration and medication abortion. Objectives: To evaluate and compare the efficacy of MVA and EVA in first trimester pregnancy termination. Methods: Study includes cases of pregnancy with less than or equal to 12 weeks of gestation. After receiving consent, cases allocated in two groups Group A followed Manual Vacuum Aspiration while Group B followed Electric Vacuum Aspiration. Each group contains 75 cases. During these procedures, relation of uterine size, blood loss, post-operative pain score, complications were noted and compared between two procedures. Results: The average blood loss was significantly higher in MVA group in more than 10 weeks of gestation. MVA is comparatively less painful than EVA. There is no major difference in complications. Conclusion: MVA is best suited for infra-structure in rural areas and is very useful in poor resource setting hence It is best suited for rural setting, where there is an unmet need for abortion services.