Abstract

PIP: A research project took place at the Department of Obstetrics and Gynaecology of Ahmadu Bello University Teaching Hospital (ABUTH) in Zaria, Nigeria, between April 1987 and May 1988 to determine the efficacy, safety, and acceptability of the manual vacuum aspiration (MVA) procedure using the Karman cannula in an outpatient facility without anesthesia to manage incomplete abortions and to determine the suitability of endometrial biopsy specimens obtained with MVA. All patients who arrived in the daytime for evacuation and all patients requiring endometrial biopsy were included in the study. 375 cases were recorded; there were 272 endometrial biopsies, 89 nonseptic abortions, 10 missed abortions, and 4 septic abortions. These subjects were interviewed for their history, treated with MVA, observed, given the contraceptive of their choice, and then discharged. The mean duration of the procedure was 3.5 minutes, with evacuation taking as long as 5-7 minutes and endometrial biopsies taking approximately 1 minute or less. Most patients spent 10-15 minutes in the hospital before discharge; no patient required hospitalization. There were very few complications (n = 6), none of them serious. Over 98% of the endometrial biopsy specimens were deemed suitable. Fewer than 5% of the patients had mild to moderate discomfort, usually during the endometrial biopsy procedures; the evacuations were virtually without discomfort. The author concluded that MVA using the Karman cannula and syringe is effective, safe, reliable, convenient, and economical for use in an outpatient setting. In addition, this procedure reduced the waiting list for dilation and curettage procedures.