Vacuum or suction aspiration uses aspiration to remove the contents of the uterus through the cervix. It may be used as an induced abortion method, therapeutic procedure used after a miscarriage, or a procedure for obtaining a sample for endometrial biopsy. The infection rate is lower than other surgical abortion procedures of 0.5%.
Some sources may use the term widening and evacuation or "suction" widening and curettage to refer to vacuum aspirations, although the terms are usually used to refer to different procedures.
Video Vacuum aspiration
Histori
Sucking as a means of removing the contents of the uterus, rather than the earlier use of hard metal curettes, was pioneered in 1958 by Drs Wu Yuantai and Wu Xianzhen in China, but their papers were translated into English only on the fiftieth anniversary of the study that "ultimately led to the technique of becoming the most common and safest midwifery procedure in the world ".
In Canada, this method was pioneered and improved by Henry Morgentaler, achieving a 0.48% complication rate and no deaths in more than 5,000 cases. He was the first doctor in North America to use this technique, which he trained for use by other doctors.
Dorothea Kerslake introduced this method to England in 1967 and published a study in the United States that further disseminated the technique.
Harvey Karman in the United States perfected this technique in the early 1970s with the development of the Karman cannula, a soft and supple cannula that avoided the need for early cervical dilatation and reduced the risk of pricking the uterus.
Maps Vacuum aspiration
Clinical use
Vacuum aspiration can be used as a method of induced abortion, as a therapeutic procedure after a miscarriage, to aid menstrual regulation, and to obtain samples for endometrial biopsy. It is also used to terminate a molar pregnancy.
When used as a treatment for miscarriage or an abortion method, vacuum aspiration may be used alone or with cervical dilatation at any time in the first trimester (up to 12 weeks' gestation). For more advanced pregnancies, vacuum aspiration can be used as a step in widening and evacuation procedures. Vacuum aspiration is a procedure used for almost all abortions in the first trimester in many countries.
Procedures
Vacuum aspiration is an outpatient procedure that generally involves a few hours clinic visit. The procedure itself usually takes less than 15 minutes. Suction is made with an electric pump (electric vacuum aspiration or EVA) or manual pump (manual vacuum aspiration or MVA). A 25cc or 50cc handheld spray can serve as a manual pump. Both methods use the same suction rate, so it can be considered equivalent in terms of effectiveness and security.
The doctor may first use local anesthesia to kill the cervix. Then, the doctor may use an instrument called a "dilator" to open the cervix, or sometimes medically cause dilation with drugs. Finally, a sterile cannula is inserted into the uterus and affixed through the tube to the pump. The pump creates a vacuum that empties the contents of the uterus.
After the procedure for the treatment of abortion or miscarriage, tissue removed from the uterus is examined for completeness. The expected content includes embryos or fetuses, as well as decidua, chorionic villi, amniotic fluid, amniotic membranes and other tissues.
Post-treatment care includes a short observation in the recovery area and follow-up appointments approximately two weeks later. This will likely include tests for infection if the biological material is not disposed of properly.
Additional drugs used in vacuum aspiration include NSAID analgesics that may have started the day before the procedure, as well as misoprostol the day before for cervical ripening.
Advantages of dilation and curettage
Dilation and curettage (D & amp; C), also known as sharp curettage, has been the standard of care in situations requiring the evacuation of the uterus. However, vacuum aspiration has a number of advantages over D & amp; C and most have replaced D & amp; C in many settings.
Vacuum aspiration may be used earlier in pregnancy than dilation and curettage (D & amp; C). Manual vacuum aspiration is the only surgical abortion procedure available earlier than the 6th week of pregnancy. Vacuum aspiration has a lower complication rate when compared to D & amp; C.
Vacuum aspiration - especially manual vacuum aspiration - is significantly cheaper than D & amp; C. The equipment required for the cost of vacuum aspiration is less than a set of curettes. While D & amp; C is generally given by doctors only, vacuum aspiration can be done by advanced practice physicians such as physician and midwife assistants.
Manual vacuum aspiration does not require electricity and can be provided in locations with unreliable or nonexistent electrical service. Manual vacuum aspiration also has the advantage of being quiet, without the sound of an electric vacuum pump.
Complications
When used for uterine evacuation, vacuum aspiration is 98% effective to remove all uterine contents. The products of conception require a second aspiration procedure. It's more common when the procedure is done very early in pregnancy, before 6 weeks gestation.
Other complications occur at levels less than 1 per 100 procedures and include excessive blood loss, infection, injury to the cervix or uterus, including perforation, and adhesion of the uterus.
References
Source of the article : Wikipedia
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