Comparison of manual vacuum aspiration, and dilatation and curettage in the treatment of early pregnancy failure

Objectives: To compare the efficacy, safety and cost effectiveness of Manual Vacuum Aspiration (MVA) with dilatation and curettage (DNC) in the management of early pregnancy failure. Methods: One hundred patients of spontaneous abortion, incomplete or missed, with gestational age <12 weeks were included in the study. Using a Random Number Table, these patients were assigned to undergo either DNC or MVA. Results: The distribution of age, parity and gestational age was similar in both groups. The mean duration of procedure was significantly higher (p<0.0001) in DNC (8.98+-2.64 minutes) as compared to 5.88+-2.43 minutes in MVA. The duration of hospital stay was significantly lower (p<0.0001) in MVA group (3.48+-1.2 hours) as compared to 7.42+-1.93 minutes in DNC group. Similarly the cost of procedure was also significantly lower (p=0.0001) in MVA group (PKR 1410+-243.4) compared to PKR 3460+-908.24 in DNC group. Conclusion: MVA is as effective as conventional dilatation and curettage for treatment of early pregnancy failure while it causes less blood loss, is less time consuming, requires a shorter hospital stay and thus costs less. It does not require general anaesthesia and complication rate is less than dilatation and curettage. (author)