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.