Manual Vacuum Aspiration in the Treatment of First Trimester Miscarriages: Experience from a Northern Nigerian Teaching Hospital

Abstract

Background: Manual vacuum aspiration (MVA) is one of the most common gynaecological procedures in clinical practice. It provides a cheap, safe and effective means of reducing maternal morbidity and mortality. Aim: The aim of the study is to review the effectiveness of manual vacuum aspiration in management of first trimester miscarriages in Aminu Kano Teaching Hospital, Kano. Materials and Method: This study was a two-year retrospective analysis (between 01/01/2017 to 31/12/2018) on the use of manual vacuum aspiration in management of first trimester miscarriages in Aminu Kano Teaching Hospital (AKTH), Kano. There were 154 cases of first trimester miscarriage during the study period but 104 case files were retrieved with complete information for analysis. Relevant data extracted were analysed using SPSS version 20. Results: One hundred and four (104) cases were analysed within the study period. Seventy-eight (75%) of the patients were aged 20-34 years; 97 (93.3%) were married and 52 (50.0%) were multigravidas. MVA was performed mainly for incomplete abortion (N=74; 71.2%). Fifty-four (51.9%) of the procedures were done by registrars and 44 (41.3%) by house-officers. Ninety-one (87.5%) of the cases had no complication; post-abortal bleeding was documented in 9 (8.7%) cases. Only 68 patients presented with histology report during their follow up visit in gynaecology clinic. 97% out of this reported product of conception, while 3% reported molar gestation. Conclusion: The most common indication for MVA in this study was incomplete abortion and most of the cases were not associated with any complication. MVA is very effective in management of first trimester miscarriage in our center. Histology report is however important as this will help to differentiate between gestational trophoblastic disease and incomplete miscarriage.