Manual Vacuum Aspiration (MVA) for Uterine Aspiration.pptx

MVa

1. M anual V acuum A s p i ra ti on ( M V A) Presented by : DR. PRIYANSHU KUMARI DR. NAJIWULLAH RAHMAN

2. What is MVA MVA meaning Manual Vacuum Aspiration - a surgical method of termination of pregnancy to enhance safe abortion within the 1 st trimester of pregnancy. MVA uses a specially designed, Hand-held Vaccum syringe with a flexible plastic cannula to apply suction in order to remove the product of conception(POC)from the uterus

3. Advantages of MVA Extremely safe – Major Complications <1% Effective – 98 to 100% Less costly as can be performed as an outpatient General anesthesia not needed

4. Mechanism of Action MVA acts via vacuum extraction of the uterine contents through a cannula Cannula is attached to the vacuum syringe which has been previously charged and locked having created a vacuum in the syringe Vacuum extracts the entire contents of the uterus with minimal damage to the lining of the uterus

5. Clinical Inductions for MVA Uterine evacuation first trimester - Induced abortion - Spontaneous abortion or early pregnancy failure(EPF) Complications management - Incomplete medical abortion - Post- abortal hematometra Uterine sampling - Endometrial biopsy

6. Uterine Evacuation Methods Recommended methods for providing uterine evacuation before 13 weeks gestation: V ac uum a s p i r ati on ( elect r i c or ma nu a l a s p i r ati on) Medical methods

7. I p a s M V A P l u s ® FDA-approved Clinical Indications Abortion P ost -a b o r t i o n care Incomplete Missed abortion E ndo m e t r i al biop s y

8. Women-centered care Infection prevention practices Clean touch technique Personal protective barriers Proper waste disposal Environmental cleanliness Proper instrument processing (0.05% chlorine solution) History & clinical assessment including pelvic/bimanual exam Counseling & consent Including post-care contraceptive counseling Prophylactic antibiotics Pain management V A procedure If desired, provision of contraceptive method of choice Post-procedure care E ss e n ti a l E l e m e n t s f o r V A p r o ce du r e

9. S t e ps of t he M V A P r o ce du r e Prepare the client. Perform cervical antiseptic prep. Perform paracervical block. 20 m L 1% li do cai ne “4 site block” Dilate cervix. Insert cannula. 2010 Renner et al, Cochrane

10. S t e ps of t he M V A P r o ce du r e ( c on t .) P r e p a re t he M V A & a s p i r at e c on te n t s . Attach prepar ed aspirator to cannula. Release buttons to start suction. G e n tl y ro tat e ca nnu l a 180 d e gr ee s i n eac h d i r ecti on. Use a gentle “in and out” motion. D o not w it hdr a w ca nnu l a op e n i ng b e yond e x te rn a l os. Inspect tissue. Perform any concurrent procedures. Take immediate post-procedure steps, including instrument processing.

11. I p a s M V A P l us Latex-free Minimum vacuum of 558.8mmHg Vacuum maintained for 30min Multiple use – Minimum 25 times Able to withstand hot or cold processing methods

12. MVA Assembly & Creating Vacuum Show & Tell

13. Cannulae For pregnancy-related use, depends on uterine size and amount of dilation: Uterine size 4–6 weeks LMP: suggest 4–7mm Uterine size 7–9 weeks LMP: suggest 6–10mm Uterine size 9–12 weeks LMP: suggest 8–12mm F or E ndo met r ia l b i op s y: 3mm size A d a p t or n ee d e d w it h Ip a s M V A p l us a s p i r at or Latex-free Single use

14. Q u e s ti on s?