What is MVA? Manual vacuum aspiration (MVA) is a method of uterine evacuation that involves use of a hand-held plastic aspirator providing a vacuum source attached to a cannula (thin tube) and manually activated to suction the uterine contents. Plastic cannulae, which vary from rigid to very flexible, are used with MVA aspirators. MVA is appropriate for treatment of incomplete abortion for uterine sizes up to 12 weeks from the last menstrual period (including miscarriage, spontaneous abortion and removal of retained products from an induced abortion), first-trimester abortion (menstrual regulation), and endometrial biopsy. Is MVA Safe? Manual vacuum aspiration is safe and effective. Most studies show that vacuum aspiration is successful in approximately 98-99 percent of cases. In a small percentage of cases ( 2%), one or more of the following can occur during or after the procedure: uterine or cervical injury, pelvic infection, vagal reaction, incomplete evacuation or acute hematometra. Be sure to discuss the risks with your physician. Compared with sharp-curettage method, use of MVA requires less cervical dilatation and is associated with less blood loss, shorter hospital stays and a reduced need for anesthetic drugs. Is an MVA procedure painful? Women undergoing an MVA generally experience three sources of discomfort: anxiety, cervical dilatation and uterine cramping. These sources require different pain-management strategies. The health-care provider should create a pain-management plan, together with the woman, in advance to reduce any physical pain and anxiety and to minimize medication-induced risks and side effects. Pain during a uterine evacuation with MVA can be reduced with a combination of verbal support, oral medications, local anesthetic to the cervix (paracervical block) and a gentle clinical technique.
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