Proper Application of Manual Vacuum Aspiration Shows Potential to Make Early Abortions Safe and Accessible: Study Shows
The Medical Termination Act (MTPA, 1971) was passed in India, allowing any woman to choose to end an undesirable pregnancy in certain circumstances. In developing countries, unsafe abortions account for 10–13 percent of maternal mortality. Lack of access to or failure to use a contraceptive method is a common cause of unwanted pregnancies. Unsafe abortions can be prevented, as can the related morbidity and mortality in women.
The most commonly used abortion methods include vacuum aspiration, sharp curettage, and medical abortion. Vacuum aspiration is the preferred procedure for terminating pregnancies in the first trimester, as it is considered safer and less painful than sharp curettage while also being more effective and less painful than certain medical abortion methods.
During vacuum aspiration, the uterine contents are removed using a plastic or metal cannula connected to a vacuum source. In electric vacuum aspiration (EVA), an electric vacuum pump generates the suction, whereas in manual vacuum aspiration (MVA), a hand-held, hand-operated plastic syringe is used to create the vacuum. MVA has been in practice for over 30 years, and opinions on its safety vary among experts. Some physicians suggest that MVA may be preferred by women due to its quieter procedure, as it does not involve machine-generated suction noise. Additionally, MVA can be performed in primary care settings at a lower cost and with greater accessibility compared to EVA.
The manual aspirator is autoclavable and easy to store, making it a practical, time-efficient, and cost-effective option for managing partial miscarriage. Both patients and clinicians recognize manual vacuum aspiration (MVA) as equally effective and safe compared to electric vacuum aspiration (EVA). While studies indicate that MVA is a safer alternative to sharp curettage for abortion, limited research has directly compared it with electric suction curettage. Existing trials suggest that both methods are equally effective and acceptable; however, their sample sizes were insufficient to draw definitive conclusions regarding safety differences.
The purpose of this study was to study EVA and MVA methods and their effectiveness in the management of early pregnancy abortion. The research was carried out at MIMER Medical College, Talegaon, Maharashtra. A total of 200 patients were investigated, with 100 randomly chosen patients receiving EVA and the remaining 100 receiving MVA. The cases were compared in terms of blood loss, days required for complete recovery, grade of pain during and after the procedure, and post-procedure complications.
In the present study, MVA seemed to be a more promising method in early pregnancy abortion when compared with EVA in terms of blood loss, days required for complete recovery, grade of pain during and after the procedure, and post-procedure complications.
The manual aspiration equipment is cost-effective, easy to use, and has been shown to have a safety and efficacy profile comparable to that of electric vacuum aspiration (EVA). Comparison of MVA and EVA shows that both appear to be equally effective in causing complete abortion. Another key aspect is that MVA is a simple, safe, and effective procedure, making it a viable alternative for various clinical settings. MVA was associated with reduced blood loss and a shorter hospital stay, making it a more efficient option for patient management.
MVA is a promising alternative to EVA, offering comparable efficacy and safety while being more accessible and widely implementable in various healthcare settings. It is associated with lower blood loss, fewer days required for complete recovery, lower grades of pain during and after the procedure, and fewer post-procedure complications.
Source: Surve et al. / Indian Journal of Obstetrics and Gynecology Research 2026;13(2):361–367
