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. 2023 Oct;163(1):302-306.
doi: 10.1002/ijgo.14836. Epub 2023 May 17.

Audit of Ireland's first manual vacuum aspiration service

A Corcoran  1 , D Hayes-Ryan  2 , V O'Dwyer  1 , S Cooley  1 , M Ramphul  1
Affiliations

Audit of Ireland's first manual vacuum aspiration service

A Corcoran et al. Int J Gynaecol Obstet. 2023 Oct.

Abstract

Introduction: Manual vacuum aspiration (MVA) is a safe and effective alternative option for the management of first-trimester miscarriage, termination of pregnancy, or retained pregnancy tissue. Ireland's first MVA clinic was set up in the Rotunda Hospital in April 2020.

Objective: To identify the number of women who have undergone MVA since establishing our service, to assess the efficacy and safety of MVA in that service, and to develop local Irish studies that further support the safety of MVA, adding to the international body of evidence.

Methods: With the approval and assistance of the Clinical Audit Committee, we obtained a log of all patients who underwent MVA in the first 18 months of the service. We performed a retrospective electronic chart review using Maternal and Newborn Clinical Management System. We collected the data and preformed a descriptive analysis.

Results: In total, 86 women underwent MVA, 85 (98.8%) of which were successfully completed. There were no immediate procedural complications, inter-hospital transfers, or emergency electric vacuum aspiration (EVA) required. We obtained an incomplete evacuation rate of 4.7% (n = 4).

Conclusion: We have demonstrated that the MVA service in the Rotunda Hospital is a safe, effective management option with advantages for both the patient and the healthcare system. We recommend consideration for provision of funding and resources to enable expansion of this service nationally in order to give women greater autonomy of choice in the management of early pregnancy complications and termination of pregnancy.

Keywords: manual vacuum aspiration; miscarriage; outpatient procedure; patient choice; termination of pregnancy.

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References

REFERENCES

    1. Institute of Obstetrics and Gynaecology, Royal College of Physicians of Ireland. Clinical Practice Guideline - Management of Early Pregnancy Miscarriage. 2012.
    1. Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland. Interim Clinical Guidance on Termination of Pregnancy Under 12 Weeks. 2018.
    1. Milingos D, Mathur M, Smith N, Ashok P. Manual vacuum aspiration: a safe alternative for the surgical management of early pregnancy loss. BJOG. 2009;116(9):1268-1271.
    1. Hemlin J, Möller B. Manual vacuum aspiration, a safe and effective alternative in early pregnancy termination. Acta Obstet Gynecol Scand. 2001;80(6):563-567.
    1. Wen J, Cai Q, Deng F, Li Y. Manual versus electric vacuum aspiration for first-trimester abortion: a systematic review. BJOG. 2007;115(1):5-13.

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