MVA (manual intrauterine aspiration) is a uterine emptying procedure indicated for the treatment of missed or incomplete abortion, or for legal abortion up to the 12th week of pregnancy.
Intrauterine manual aspiration is considered a simple, safe and effective procedure, with a lower risk of complications than curettage, however, it is important to talk to the doctor about the risks and carry out adequate preparation.
MVA is performed by a gynecologist in a clinic or hospital, under sedation, and local anesthesia may also be performed using a vacuum syringe, and the woman is generally released to go home on the same day.
When is it indicated
MVA is indicated for uterine emptying in the following cases:
- Missed or incomplete abortion;
- Hydatidiform mole;
- Retention of placental remains;
- Anembryonic pregnancy (without embryo);
- Infected or unavoidable miscarriage;
- Endometrial biopsy.
Furthermore, in Brazil this procedure is authorized for legal abortion in the following situations: pregnancy resulting from rape, risk of maternal death or anencephalic fetus.
Intrauterine manual aspiration is a simple procedure, performed by a gynecologist and can be done up to the 12th week of pregnancy.
If you want an evaluation by a gynecologist, schedule an appointment in the nearest region:
Taking care of your health has never been easier!
What is the difference between MVA and curettage?
Both MVA and curettage are indicated for uterine emptying in cases of missed or incomplete abortion and performed transvaginally.
However, MVA is a procedure that uses a syringe that creates a vacuum and a flexible plastic cannula that has no tip to aspirate the contents of the uterus, which reduces the risk of uterine perforation, and can be performed up to the 12th week. of pregnancy.
Curettage, on the other hand, uses a curette, which is a metallic device with a tip for scraping the uterus, which increases the risk of perforation, and can be done in pregnancies over 12 weeks. See how curettage is done.
How to prepare
To prepare for MVA, it is important to clarify with your gynecologist all your doubts about the procedure, possible risks and recovery.
In addition, you must inform your doctor if you are allergic to any medication, as sedation and regional anesthesia of the cervix are performed in some cases.
Before carrying out the procedure, the doctor must order an ultrasound to confirm the gestational age and perform a gynecological examination to assess the shape, position and size of the uterus.
It is also important that women have psychological support before and after the procedure.
How it is made
MVA is performed by the gynecologist in the hospital, under sedation, and local anesthesia of the cervix may also be performed. Before starting the procedure, the woman is given antibiotics to prevent infections.
The procedure is carried out intravaginally with the woman in the gynecological position, after emptying the bladder, using an aspirator syringe with a double valve and cannulas of different sizes, according to the gestational age.
To perform manual intrauterine aspiration (MVA), the doctor must follow some steps, which are:
- Saline administration in vein and sedation;
- Inserting a small instrument into the vaginacalled a vaginal speculum, the same one used in routine gynecological examinations, to allow visualization of the cervix;
- Attaching a clampcalled Pozzi forceps, on the anterior lip of the cervix, to position the cervical canal;
- Cleaning the cervix with antiseptic solution;
- Application of local anesthesiawith lidocaine, in the cervix, if necessary;
- Dilation of the cervix with the MVA cannula or mechanical dilators;
- Introduction of the MVA cannula inside the uterine cavity;
- Preparing the MVA aspirator syringeand then fixing the syringe on the cannula;
- Aspiration of uterine contents vacuum;
- Watch for signs that the uterus is completely emptysuch as red or pink tissue-free foam coming out of the cannula, a feeling of roughness on the surface of the uterus and contraction of the uterus around the cannula;
- Removal of the cannula by LOVE
After the procedure, the doctor must inspect the aspirated contents of the uterus to ensure that the contents of the uterus have been completely removed.
During the procedure, the doctor can use an ultrasound to guide the insertion of the cannula and visualize the uterus from the inside while it is emptying, in addition to inserting an IUD if the woman has requested it and is indicated.
MVA is a safe and quick procedure lasting around 30 minutes, and after its completion, the woman is taken to an observation room and can be released to go home the same day.
What is recovery like?
Recovery from MVA can take a few weeks, and after the procedure the woman may experience a small amount of bleeding.
Additionally, the woman may have cramps that improve with the use of painkillers prescribed by the doctor.
It is also important that women have psychological support, especially when MBF was performed due to miscarriage, as a way of overcoming grief.
What does the uterus look like after MVA?
After MVA, the uterus may take a few weeks to recover and the menstrual cycle should return to normal within 4 to 6 weeks.
During this period, it is important that women avoid intimate contact, as advised by the gynecologist.
Is it possible to get pregnant after MVA?
A woman can become pregnant after MVA, because ovulation occurs normally, and fertility can return to normal around 15 days after the procedure, unless the woman is using hormonal contraceptive methods.
However, although there is no consensus, the doctor may recommend waiting around 3 to 6 months to try to get pregnant, but this varies from woman to woman, and guidance from the gynecologist should always be taken.
Possible risks
MVA is a procedure considered safe, but it may carry the risk of uterine perforation, although this is a lower risk compared to curettage.
Furthermore, other risks of MVA are incomplete emptying of the contents of the uterus, which may require curettage, infections or heavy bleeding, and the use of misoprostol may be necessary to reduce bleeding. See what misoprostol is for.
Furthermore, as with any procedure in which sedation is performed, allergic reactions or side effects may occur, such as dizziness, nausea, vomiting, restlessness or agitation.
Who shouldn’t do
MVA should not be performed after the 12th week of pregnancy or in cases of women who have a dilation of the cervix greater than 12 mm.
