Abstract

OBJECTIVES:

To assess the impact of the manual vacuum aspiration (MVA) technique on health care services and its acceptability to patients and staff.

DESIGN:

Prospective descriptive survey.

SETTING:

The university teaching hospital, Blantyre, Malawi.

PARTICIPANTS:

All 456 patients who had MVA for treatment or investigation between 10 January and 9 April 1994, the nurses and doctors working in the unit and hospital administrators.

MAIN OUTCOMES:

Proportion of incomplete abortion patients who had MVA, the need for pain relief, patients' reactions, staff opinion, and reduction in ward occupancy rates and duration of hospitalisation.

RESULTS:

Of the total, 97.4% had MVA for treatment of incomplete abortion; these comprised 81.2% of all incomplete abortion patients treated during the study period. The mean volume of uterine contents was 33.4 ml. There was no relationship between the volume and either the gestational age or uterine size (P > 0.05). Only 10.7% of patients required pain relief. The bed occupancy rates in the gynaecological ward dropped from an average of 150% before to 130% after the introduction of MVA, and the mean hospital stay was reduced from 3 days, with 78.4% staying for more than 2 days, to 2 days, with 52% staying for less than 24 hours (P < 0.05). Most patients expressed general satisfaction with the method, while the staff were happler because their work had been made easier. There were no major complications associated with the procedure.

CONCLUSION:

The findings show that MVA is a safe, reliable, effective and acceptable method of treating incomplete abortion, and can conserve hospital resources.