Vacuum Aspiration

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Vacuum Aspiration, also known as suction aspiration or suction abortion, is a common surgical procedure used to terminate a pregnancy in the first trimester. It is also performed to clear the uterus after a miscarriage or an incomplete medical abortion.

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How It Works

Vacuum Aspiration typically involves the following steps: 

• Preparation - The patient lies on their back with feet in stirrups. A speculum is inserted to hold the vaginal walls open. A local anesthetic is injected into or near the cervix to numb the area. For some procedures, especially later in the first trimester, sedation or general anesthesia may be used.

• Dilation - The doctor may use thin metal rods, called dilators, to gently widen the cervix. In some cases, medication such as misoprostol may be used beforehand to help soften the cervix.

• Aspiration - A thin, flexible tube, called a cannula, is inserted through the cervix into the uterus. The other end of the cannula is attached to either a manual suction device (syringe) or an electric pump.

• Evacuation - Gentle suction is used to remove the pregnancy tissue from the uterus. The doctor may rotate the cannula to ensure the uterus is completely emptied. In some cases, a small, loop-shaped instrument called a curette may also be used.

There are two main methods of vacuum aspiration: 

• Manual Vacuum Aspiration (MVA) - Performed earlier in pregnancy (up to 10 weeks), this method uses a hand-held syringe to create suction. MVA is quiet and does not require electricity, which makes it suitable for office-based or low-resource settings.

• Electric Vacuum Aspiration (EVA) - This method uses an electric pump to create continuous suction. It may be used for more advanced first-trimester pregnancies. 

Risks and Complications

Risks can include: 

• Infection - Occurs in a small number of cases.

• Incomplete abortion - Some pregnancy tissue remains in the uterus, possibly requiring a repeat procedure.

• Heavy bleeding - A rare but serious complication.

• Uterine perforation - A tear in the uterine wall, which is extremely rare.

• Injury to the cervix - Damage to the cervical tissue.