Re‐defining Care: Australia’s First Outpatient Manual Vacuum Aspiration Service for the Surgical Management of Miscarriage

ABSTRACT Background Outpatient manual vacuum aspiration (MVA) has been recently implemented in Australia as an option for the management of first‐trimester miscarriage. In other international settings, it has been shown to be a safe and effective alternative to suction dilatation and curettage (D&C). Our study presents the outcomes of outpatient MVA under local anaesthetic compared to suction D&C under general anaesthetic. This service is the first to be established in Australia. Aims To evaluate the safety and efficiency of manual vacuum aspiration curettage (MVA) as a management option for early pregnancy loss, to determine if this procedure is equivalent to conventional surgical treatment. Materials and Methods A retrospective clinical audit was conducted at a regional tertiary teaching hospital to compare the rates of complications (haemorrhage, return to theatre, procedure failure and readmission) and length of stay between suction dilatation (D&C) and MVA for the management of first‐trimester miscarriage. Results MVA was associated with significantly less blood loss ( p < 0.001) and length of stay ( p < 0.001) compared with suction D&C. Overall readmission rates were similar between the two groups, with MVA more likely to be complicated by retained products of conception, whilst patients undergoing a D&C were more likely to be readmitted with pain or endometritis. Conclusions MVA is a safe alternative to suction D&C for the management of first‐trimester miscarriage, with reduced hospital length of stay compared with D&C.