Dodge Laura E, Hofler Lisa G, Hacker Michele R, Haider Sadia
Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, KS 3, Boston, MA 02215 USA.
Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115 USA.
Contracept Reprod Med. 2017 Jun 7;2:18. doi: 10.1186/s40834-017-0045-6. eCollection 2017.
Outpatient manual vacuum aspiration (MVA) is a safe and equally effective alternative to electric vacuum aspiration (EVA) in the operating room. This project was conducted to determine whether outpatient MVA expedites care while maintaining patient satisfaction.
A cross-sectional study of a convenience sample of patients undergoing surgical management of spontaneous abortion, induced abortion, or retained products of conception with either outpatient MVA under local anesthesia or EVA in the operating room was conducted. Of 138 women completing surveys, 48 (34.8%) underwent outpatient MVA and 90 (65.2%) underwent EVA in the operating room. Procedure length, time from decision to procedure, and patient satisfaction were assessed through a self-administered questionnaire completed post-procedure.
Most (77%) patients in the MVA group reported waiting fewer than 2 h from the time of their decision to the procedure, while most (74%) EVA patients reported waiting over 12 h ( < 0.001); the MVA group reported higher satisfaction with time to procedure ( = 0.02). The median procedure length was significantly shorter in the EVA group (10 vs. 20 min, < 0.001). There was no significant difference between groups in overall satisfaction with the procedure ( = 0.16).
Outpatient MVA under local anesthesia is a suitable alternative to operating room-based EVA for management of spontaneous abortion, induced abortion, and retained products of conception. Outpatient MVA is associated with shorter decision-to-procedure time and is highly acceptable to patients. Integration of outpatient MVA into clinical settings can add time- and resource-saving options for uterine evacuation while maintaining a positive patient experience.
门诊手动真空抽吸术(MVA)是手术室电动真空抽吸术(EVA)的一种安全且同样有效的替代方法。开展本项目旨在确定门诊MVA在保持患者满意度的同时是否能加快治疗进程。
对接受自然流产、人工流产或稽留流产手术治疗的患者进行便利抽样横断面研究,这些患者分别接受局部麻醉下的门诊MVA或手术室EVA。在138名完成调查的女性中,48名(34.8%)接受了门诊MVA,90名(65.2%)在手术室接受了EVA。通过术后自行填写的问卷评估手术时长、从决定手术到实施手术的时间以及患者满意度。
MVA组大多数(77%)患者报告从决定手术到实施手术的等待时间少于2小时,而EVA组大多数(74%)患者报告等待时间超过12小时(P<0.001);MVA组对手术时间的满意度更高(P=0.02)。EVA组的中位手术时长明显更短(10分钟对20分钟,P<0.001)。两组对手术的总体满意度无显著差异(P=0.16)。
局部麻醉下的门诊MVA是手术室EVA用于治疗自然流产、人工流产和稽留流产的合适替代方法。门诊MVA与更短的决定手术到实施手术的时间相关,且患者接受度高。将门诊MVA纳入临床环境可为子宫排空增加节省时间和资源的选择,同时保持患者的良好体验。