Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Hong Kong SAR, China.
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.
Hong Kong Med J. 2023 Jun;29(3):233-239. doi: 10.12809/hkmj2210127. Epub 2023 May 25.
Manual vacuum aspiration is increasingly accepted as an alternative to medical or surgical evacuation of the uterus after first-trimester miscarriage. This study aimed to assess the efficacy of ultrasound-guided manual vacuum aspiration (USG-MVA) in the management of first-trimester miscarriage.
This retrospective analysis included adult women with first-trimester miscarriage who underwent USG-MVA in Hong Kong between July 2015 and February 2021. The primary outcome was the efficacy of USG-MVA in terms of complete evacuation of the uterus, without the need for further medical or surgical intervention. Secondary outcomes included tolerance of the entire procedure, the success rate of karyotyping using chorionic villi, and procedural safety (ie, any clinically significant complications).
In total, 331 patients were scheduled to undergo USG-MVA for first-trimester miscarriage or incomplete miscarriage. The procedure was completed in 314 patients and well-tolerated in all of those patients. The complete evacuation rate was 94.6% (297/314), which is similar to the rate (98.1%) achieved by conventional surgical evacuation in a previous randomised controlled trial in our unit. There were no major complications. Samples from 95.2% of patients were suitable for karyotyping, which is considerably higher than the rate of suitable samples (82.9%) obtained via conventional surgical evacuation in our previous randomised controlled trial.
Ultrasound-guided manual vacuum aspiration is a safe and effective method to manage first-trimester miscarriage. Although it currently is not extensively used in Hong Kong, its broader clinical application could avoid general anaesthesia and shorten hospital stay.
手动吸引术越来越被认为是早孕流产后子宫清除的一种替代方法，可替代药物或手术清宫。本研究旨在评估超声引导下手动吸引术（USG-MVA）在早孕流产管理中的疗效。
本回顾性分析纳入 2015 年 7 月至 2021 年 2 月期间在香港因早孕流产而接受 USG-MVA 的成年女性。主要结局是 USG-MVA 完全清除子宫的疗效，无需进一步药物或手术干预。次要结局包括整个手术过程的耐受性、绒毛组织进行核型分析的成功率以及手术安全性（即任何有临床意义的并发症）。
共有 331 例患者因早孕流产或不全流产而计划接受 USG-MVA。314 例患者完成了手术，所有患者均能耐受。完全清除率为 94.6%（297/314），与我们单位之前的一项随机对照试验中常规手术清宫的清除率（98.1%）相似。无重大并发症。95.2%的患者样本适合核型分析，明显高于我们之前的随机对照试验中常规手术清宫的合适样本率（82.9%）。
超声引导下手动吸引术是一种安全有效的管理早孕流产的方法。尽管它目前在香港尚未广泛应用，但它的广泛临床应用可以避免全身麻醉并缩短住院时间。
