Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537- 3 Iguchi, 329-2763, Nasushiobara City, Tochigi, Japan.
Center for Human Reproduction, International University of Health and Welfare Hospital, 537-3 Iguchi, 329-2763, Nasushiobara City, Tochigi, Japan.
BMC Pregnancy Childbirth. 2020 Nov 16;20(1):695. doi: 10.1186/s12884-020-03362-4.
The World Health Organization does not recommend dilatation and sharp curettage (D&C) for the surgical treatment of miscarriage during the first trimester because this may cause Asherman's syndrome due to endometrial damage; therefore, suction remains the primary treatment option. While manual vacuum aspiration (MVA) has been widely used since the 1990s outside Japan, the use of an MVA device (Women's MVA system) was approved in Japan in October 2015. Here, we examined the efficacy of the MVA kit in women surgically treated for miscarriage.
This retrospective cohort study was conducted between 2014 and 2018 at the International University of Health and Welfare Hospital in Japan. Women who underwent surgical treatment for miscarriage within 12 weeks of pregnancy were identified and enrolled in the study. A total of 404 women were included who underwent the following procedures: 121 D&C, 123 electric vacuum aspiration (EVA), and 160 MVA. For each participant, the duration of surgery, amount of bleeding, amount of anesthetic used, incomplete abortion requiring repeat procedures, and intraoperative/postoperative complications were evaluated.
The duration of surgery was 13.7 ± 7.2, 11.2 ± 4.2, and 6.9 ± 4.3 min in the D&C, EVA, and MVA groups, respectively (p = 1.00). The amount of anesthetic used was not significantly different among all groups. Bleeding of ≥ 100 mL was confirmed in three (2.4%), one (0.8%), and one (0.6%) patient(s) in the D&C, EVA, and MVA groups, respectively (p = 0.50). Incomplete abortion was identified in three (2.4%), two (1.6%), and one (0.6%) patient(s) in the D&C, EVA, and MVA groups, respectively (p = 0.61). However, severe intraoperative/postoperative complications were not observed in any group.
Surgical treatment for miscarriage performed using the MVA kit has safety and efficacy similar to those of conventional methods, such as D&C and EVA.
世界卫生组织不建议在妊娠早期使用扩张和刮宫术（D&C）进行手术治疗流产，因为这可能会导致子宫内膜损伤引起的 Asherman 综合征；因此，吸引术仍然是主要的治疗选择。虽然手动吸引术（MVA）自 20 世纪 90 年代以来在日本以外的地区得到广泛应用，但 2015 年 10 月日本批准使用 MVA 设备（女性 MVA 系统）。在这里，我们检查了 MVA 套件在因流产而接受手术治疗的女性中的疗效。
这项回顾性队列研究于 2014 年至 2018 年在日本国际医疗福祉大学医院进行。确定了在妊娠 12 周内接受手术治疗流产的女性，并将其纳入研究。共纳入 404 名接受以下程序的女性：121 例 D&C、123 例电动吸引术（EVA）和 160 例 MVA。对于每个参与者，评估手术持续时间、出血量、麻醉剂使用量、需要重复手术的不完全流产以及术中/术后并发症。
D&C、EVA 和 MVA 组的手术时间分别为 13.7±7.2、11.2±4.2 和 6.9±4.3 分钟（p=1.00）。所有组之间的麻醉剂使用量无显着差异。D&C、EVA 和 MVA 组各有 3 例（2.4%）、1 例（0.8%）和 1 例（0.6%）患者的出血量≥100ml（p=0.50）。D&C、EVA 和 MVA 组各有 3 例（2.4%）、2 例（1.6%）和 1 例（0.6%）患者的不完全流产（p=0.61）。然而，任何一组均未观察到严重的术中/术后并发症。
使用 MVA 套件进行的流产手术治疗具有与 D&C 和 EVA 等传统方法相似的安全性和疗效。
