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Table 3 Characteristics of studies investigating the use of MVA in the management of early pregnancy loss

From: Manual vacuum aspiration under local anaesthetic for early miscarriage: 2 years experience in a university teaching hospital in UK

Study

Study period

Study design

Participants

Setting

Interventions

Comparison

Conclusions

Blumenthal and Remsburg [15]

1990–1992

Open, serial, quasi-experimental

35 women with first trimester incomplete abortions

OT, ER or LW, USA

Outpatient MVA under sedation using Fentanyl or Midazolam

Electrical suction curettage in OT

Significant reduction in both procedure time (42 %) and costs (41 %) with MVA

Egziabher et al. [22]

1997

Double blind RCT

142 women with incomplete miscarriage

Health Centre, Nairobi

MVA under paracervical block with 1 % lignocaine (LA)

MVA under paracervical block with sterile water

LA significantly reduced pain during MVA

Gazvani et al. [14]

1998–2000

Prospective

57 women with first trimester miscarriage

OT, UK

MVA under systemic analgesia using IV Alfentanil or Midazolam

MVA under patient controlled sedation

No significant differences in MVA success and acceptability rates (100 %) between the anaesthetic techniques

Edwards et al. [10]

2002–2004

RCT, multicenter, non inferiority

157 women with first trimester miscarriage

OT, ER USA

MVA under LA

EVA under GA or spinal anaesthesia

MVA success rate 97 % vs. EVA 95.2 %, MVA acceptability 70 % vs. EVA 77 %

Milingos et al. [17]

2003–2005

Retrospective observational study

245 women with first trimester miscarriage

EPAU, UK

MVA under LA

None

MVA success rate 94.7 %

Tasnim et al. [23]

2007–2008

RCT

176 women with early pregnancy failure

OT, Pakistan

MVA under paracervical block

EVA under GA

MVA success rate 90 % vs. EVA 91 %, Significant less blood loss, shorter hospital stay and reduced cost with MVA

Kinariwala et al. [24]

2011–2012

Retrospective case series

9 women with early pregnancy failure

A&E, USA

MVA under paracervical 1 % lidocaine, IV and oral analgesia

None

MVA success rate 100 %

  1. MVA manual vacuum aspiration, OT operation theatres, ER outpatient emergency or procedure room, LW labour ward, RCT randomised controlled trial, LA local anaesthetic, IV intravenous, EVA electric vacuum aspiration, GA general anaesthesia, EPAU early pregnancy assessment unit, A&E accident and emergency