SAN FRANCISCO — The manual vacuum aspirator is an important but often neglected tool for pregnancy terminations, Dr. Frederick W. Hopkins said at a conference on contraceptive technology sponsored by Contemporary Forums.
“We've done a lot of educating women about medical abortion,” said Dr. Hopkins, an ob.gyn. in group practice in San Jose, Calif. “We haven't done as much education about how gentle and brief early surgical abortion is. And [the manual vacuum aspirator] can be very well utilized in the emergency room [with] women who are having miscarriages.” Its use can help avoid a trip to the operating room.
“In the developing world, this instrument is saving women's lives,” he added.
There's little practical difference between the electric vacuum aspirator (EVA) and the manual vacuum aspirator (MVA). The only difference is the source of the vacuum. One advantage of the EVA is that it provides a limitless source of suction. The suction in the MVA needs to be recharged occasionally.
On the other hand, the MVA is much quieter than the EVA. Because some physicians believe that patients will associate the noise of the electric motor with the pain of their uterine contractions, the EVA unit is placed in another room, its suction tubes coming through the wall.
Although some believe that the EVA can help physicians complete the procedure more rapidly, Dr. Hopkins said “with the MVA, in 30 seconds I can empty a uterus for somebody who's less than 8 weeks [pregnant].”
The MVA has the additional advantages of being reusable and portable and of not requiring a source of electrical power. Even when Dr. Hopkins is using an EVA, “I always have an MVA next to me in case the electricity goes out.”
And he finds that the MVA is somewhat gentler on the tissue it extracts. The gestational sac often becomes shredded by an EVA, while the sac tends to remain intact with an MVA. This makes it simpler to identify the products of conception, ensuring that the procedure is complete and saving the time and expense of subsequent pregnancy testing. This is especially important in rural communities or other situations in which women must travel long distances for an abortion.
For the same reason, the MVA can allow an early diagnosis of ectopic pregnancy.
At least five studies of more than 17,000 patients demonstrated efficacy rates of 98%–99% for MVA, Dr. Hopkins said.
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