A Comparative Study between the use of Manual Vacuum Aspiration (MVA) and Conventional Dilatation and Curettage (D&C) in the Management of Incomplete Miscarriage

This study focused on comparing the MVA and D&C, in terms of safety and efficacy in uterine evacuation for the management of clinically diagnosed pregnancies end in miscarriage. Randomized Control Trial was carried out in Alfashir Hospital in Northern Darfur, Sudan, between March and September of 2022. The study involved 200 women diagnosed with spontaneous and first-trimester miscarriage. One hundred women were managed using MVA, and the remaining 100 were managed with conventional D&C. 38% of cases were <25-year ,46% of cases were <35y and 16% of cases were <50y. Regarding the gestational age, 9% of cases were <6 weeks, 47.5% were 6-9 weeks, 24.5% were 10-12 weeks and 19% were 13-14weeks. According to time duration of the procedure, 35% of the cases are done in <5 min, 31% done between 6-10 min, 15% done in <15 min and 19% done in >15 min. According to the need for analgesia and anesthesia, all cases of D&C were done under analgesics and anesthesia, and 73% of MVA cases used analgesics. Regarding the blood loss, only one case in the MVA group had sever blood loss, however 6 cases had significant blood loss. One case in the D&C group had uterine perforation and no perforation in the other group. 2 cases had anesthetics complications and no anesthetics complication in the MVA group. Regarding the retained product of conception, both groups were completely evacuated without the need for re-evacuation. In conclusion Both MVA and D&C are equally effective in uterine evacuation and the possibility of returned product of conception after uterine evacuation is extremely rare, compared to D&C, MVA had a substantially lower rate of complications, procedure length, blood loss and bleeding.