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Surgical procedures to evacuate incomplete miscarriageForna F, Gülmezoglu AM
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SummarySurgical procedures to evacuate incomplete miscarriageVacuum aspiration is a safe and quick treatment for incomplete abortions. Bleeding and infection generally result if the uterus is not emptied after incomplete abortion (where parts of the products of conception are left in the uterus). The review of trials found that vacuum aspiration (a procedure that empties the uterus by using a vacuum source with or without electricity) was safe, quick and easy to perform. It was also less painful than dilatation and curettage, which is often done under general anesthesia in an operating room.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2009 Issue 4, Copyright © 2009 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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January 22. 2001 AbstractBackgroundIncomplete abortion is a major problem that should be effectively managed with safe and appropriate procedures. Surgical evacuation of the uterus for management of incomplete abortion usually involves vacuum aspiration or sharp curettage. ObjectivesTo compare the safety and effectiveness of surgical uterine evacuation methods for management of incomplete abortion. Search strategyWe searched the Cochrane Pregnancy and Childbirth Group trials register (December 2002), Medline from 1966, Popline from 1970, and the Cochrane Controlled Trials Register. Trials were also identified from reference lists of reviews. Date of last search: December 2002. Selection criteriaRandomized trials where different surgical methods were used to manage incomplete abortion were eligible for inclusion. Data collection and analysisWe extracted population characteristics, settings, and exclusion criteria, in addition to outcomes such as complications of the procedure, duration, need for re-evacuation, blood transfusion, and analgesia/anesthesia. Main resultsTwo trials were included. Vacuum aspiration was associated with statistically significantly decreased blood loss (-17 mls weighted mean difference, 95% confidence interval (CI) -24 to -10 mls), less pain (relative risk (RR): 0.74, 95% CI 0.61, 0.90), and shorter duration of procedure (-1.2 minutes weighted mean difference, 95% CI -1.5 to -0.87 minutes), than sharp curettage, in the single study that evaluated these outcomes. Serious complications such as uterine perforation and other morbidity were rare and the sample sizes of the trials were not large enough to evaluate small or moderate differences. Authors' conclusionsVacuum aspiration is safe, quick to perform, and less painful than sharp curettage, and should be recommended for use in the management of incomplete abortion. Analgesia and sedation should be provided as necessary for the procedure. |