A Comparative Study of Manual Vacuum Aspiration (MVA) and Electric Vacuum Aspiration (EVA) for the Surgical Management in Pregnancy Termination of Upto 10 Weeks Gestation

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Abstract (English)

Introduction: Termination of pregnancy in the first trimester is one of the most commonly performed 
gynecological procedures worldwide. Both Manual Vacuum Aspiration (MVA) and Electric Vacuum Aspiration 
(EVA) are established methods for surgical management of early pregnancy termination. While both techniques 
are considered safe and effective, differences may exist in terms of efficacy, safety profile, complications, 
procedure time, and patient acceptability. 
Objectives: To compare the outcomes of Manual Vacuum Aspiration (MVA) and Electric Vacuum Aspiration 
(EVA) for pregnancy termination up to 10 weeks of gestation. 
Methods: This hospital-based prospective randomized comparative study was conducted over one year in the 
Department of Obstetrics & Gynecology at Chittaranjan Seva Sadan College. It included 200 women with first
trimester abortion (≤10 weeks) who met the Government of India MTP criteria. Patients were randomized to 
undergo either Manual Vacuum Aspiration (MVA) or Electric Vacuum Aspiration (EVA), and data were 
collected on age, gravida, gestational age, locality, and socioeconomic status, cause of abortion, bleeding, 
complications, pain, and post-abortal contraceptive practices to compare outcomes between the two groups. 
Results: In this study of 200 patients, the MVA and EVA groups were comparable in age distribution, with the 
majority in the 21–30 years range (MVA: 71%, EVA: 64%; p=0.466) and similar gravida status (p=0.74), while 
gestational age showed a significant difference (p=0.02), with more patients at 5 weeks in the MVA group (5%) 
and more at 10 weeks in the EVA group (28%). Socioeconomic status also differed significantly (p=0.044), with 
a higher proportion of lower socioeconomic patients in the MVA group (77% vs 64%). Blood loss increased 
with gestational age, with MVA consistently lower than EVA (6 weeks: 23.5 ml vs 27.5 ml, p<0.001; 8 weeks: 
28.46 ml vs 35.03 ml, p<0.001; 9 weeks: 33.4 ml vs 38.86 ml, p=0.01; 10 weeks: 36.29 ml vs 43.49 ml, p<0.001; 
7 weeks difference not significant, 28.5 ml vs 32.3 ml, p=0.076). Hospital stay was shorter with MVA across all 
gestational ages (6–6.67 days) compared to EVA (13.2–15 days), with significant differences at 6, 8, 9, and 10 
weeks. Grade I bleeding was more frequent in MVA (69% vs 13%), while higher grades occurred more in EVA 
(p<0.001). Pain was also lower with MVA (Grade I: 37% vs 0%; Grade IV: 7% vs 54%; p<0.001). Overall 
complications (p=0.215) and post-abortal contraceptive practices (p=0.345). 
Conclusion: Manual Vacuum Aspiration and Electric Vacuum Aspiration are both safe and effective techniques 
for surgical termination of pregnancy up to 10 weeks. MVA is particularly advantageous in resource-limited 
settings, while EVA may be more suitable in facilities with adequate infrastructure. The choice of method 
should be individualized based on patient preference, clinical setting, and resource availability.