Re-defining Care: Australia's First Outpatient Manual Vacuum Aspiration Service for the Surgical Management of...

Outpatient manual vacuum aspiration (MVA) has been recently implemented in Australia as an option for the management of first-trimester miscarriage. In other international settings, it has been shown to be a safe and effective alternative to suction dilatation and curettage (D&C). Our study presents the outcomes of outpatient MVA under local anaesthetic compared to suction D&C under general anaesthetic. This service is the first to be established in Australia.

To evaluate the safety and efficiency of manual vacuum aspiration curettage (MVA) as a management option for early pregnancy loss, to determine if this procedure is equivalent to conventional surgical treatment.

A retrospective clinical audit was conducted at a regional tertiary teaching hospital to compare the rates of complications (haemorrhage, return to theatre, procedure failure and readmission) and length of stay between suction dilatation (D&C) and MVA for the management of first-trimester miscarriage.

MVA was associated with significantly less blood loss (p < 0.001) and length of stay (p < 0.001) compared with suction D&C. Overall readmission rates were similar between the two groups, with MVA more likely to be complicated by retained products of conception, whilst patients undergoing a D&C were more likely to be readmitted with pain or endometritis.

MVA is a safe alternative to suction D&C for the management of first-trimester miscarriage, with reduced hospital length of stay compared with D&C.