Management of incomplete abortion with manual vacuum aspiration in comparison to sharp metallic curette in an Ethiopian setting

Abstract

This institution based case control study emanated from the fact that manual vacuum aspiration (MVA) has been recently introduced in Ethiopia and Gandhi Memorial hospital is currently serving as the pioneering centre. Abortion is an important everyday medicolegal, social, political and public health issue. The objectives of the study were to focus on abortion issues, to show that MVA is alternative instrument applicable in our setting and to highlight some of the determinants that can influence the choice of instruments in the management of incomplete abortions of less than 12 weeks of gestation. A total of 1896 patients who fulfilled the inclusion criteria underwent evacuation and curettage with MVA and SMC during the study period. The main considered variables included socio-demographic characteristics, service-providers, complications in relation to operators and method of surgery, duration of the surgery, patient pain evaluation and uterine factors. MVA is found to be equally safe, effective, simple and fast set of instruments which can be employed in the management of incomplete abortions. Integration of MVA in the medical training is recommended as it is a measure which can greatly contribute towards the reduction of maternal morbidity and mortality especially in a developing country like ours where resources are scare and alternatives are quite limited.

PIP: This institution-based case-control study emanated from the fact that manual vacuum aspiration (MVA) has been recently introduced in Ethiopia and Gandhi Memorial hospital is currently serving as the pioneering center. Abortion is an important medicolegal, social, political, and public health issue. The objectives of the study were to focus on abortion issues, to show that MVA is an alternative procedure applicable in the authors' setting, and to highlight some of the determinants that can influence the choice of procedure in the management of incomplete abortions of less than 12 weeks gestation. A total of 1896 patients who fulfilled the inclusion criteria underwent MVA or sharp metallic curettage during the study period. The main variables considered included sociodemographic characteristics, service providers, complications in relation to operators and method of surgery, duration of the surgery, patient pain evaluation, and uterine factors. MVA was found to be equally safe, effective, simple, and fast in the management of incomplete abortions. Integration of MVA in the medical training is recommended, as it is a measure which can greatly contribute towards the reduction of maternal morbidity and mortality especially in a developing country like the authors', where resources are scare and alternatives are quite limited.