CONTENTS

         Chapters
  1. Women's Lives At Risk
  2. Planning Care to Save Women's Lives
  3. Complete Care: Providing Family Planning
  4. Appropriate Care: MVA and Local Anesthesia
  5. Prompt Care: Referral and Decentralization

HIGHLIGHTS

Population Reports is published by the Population Information Program, Center for Communication Programs, The Johns Hopkins School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202-4012, USA


Volume XXV, Number 1
September, 1997
Appropriate Care:
     MVA and Local Anesthesia


The vast majority of women seeking emergency care for abortion complications are suffering from incomplete abortion. Incomplete abortion means that the uterus has not been completely emptied and contains retained tissue. If not treated promptly with uterine evacuation, incomplete abortion can cause hemorrhage or infection, which can then lead to death (277, 282). In most cases, manual vacuum aspiration (MVA) under local anesthesia is the appropriate treatment for postabortion complications. MVA is preferable to sharp curettage (also known as dilation and curettage, or D&C), the technique that is still most often used in much of the world (94, 186, 277, 282).

Switching from sharp curettage to vacuum aspiration for treating complications through 12 weeks' gestation is central to improving postabortion care in developing countries. In most developing countries, switching to vacuum aspiration means introducing manual vacuum aspiration. While electric vacuum aspiration is also appropriate for postabortion care, its availability is limited in developing countries. The World Health Organization (WHO) recognizes vacuum aspiration as the most appropriate method for treating early incomplete abortion. In fact, WHO considers MVA an essential element of care at the first referral level of all health care systems (282, 283).


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