Treatments for Early Pregnancy Miscarriage - USG-MVA

According to statistics, miscarriage occurs in 10% to 20% of pregnancies, and approximately one in four women will experience a miscarriage in their lifetime. Recurrent miscarriage refers to experiencing two or more consecutive natural miscarriages. Although miscarriage can be distressing, with proper treatment, women can still successfully conceive and give birth in the future.

Traditional treatments for early pregnancy miscarriage mainly involve "medical abortion" and "traditional dilation and curettage (D&C) surgery." Traditional D&C surgery requires hospitalization and is performed in an operating room under general anesthesia. It involves scraping the uterus with metal instruments, which may cause damage to the cervix, uterine perforation, or bleeding and infection due to incomplete removal of all remaining tissue. It is estimated that about 20% of women who have undergone traditional D&C surgery may experience uterine adhesion problems after surgery, affecting future pregnancy opportunities and contributing to recurrent miscarriage.

Hong Kong has introduced a new technology - "Ultrasound-Guided Manual Vacuum Aspiration (USG-MVA)", which can reduce the problems caused by traditional D&C surgery, providing women with an alternative that does not require hospitalization or general anesthesia.
 

What is Ultrasound-Guided Manual Vacuum Aspiration?

Ultrasound-Guided Manual Vacuum Aspiration (USG-MVA) is a safe and effective alternative method for surgical management of miscarriage. Compared to traditional surgical management, USG-MVA has the following advantages:

• Can be performed in an outpatient setting without hospitalization
• Monitored anesthesia is used during the procedure, no general anesthesia is needed
• USG-MVA is performed by the use of a specially designed manual vacuum aspiration syringe to apply suction to remove the tissue of the miscarriage, does not require the use of an electric suction machine, therefore reducing the risk of surgery
• The procedure is performed under ultrasound supervision, allowing the doctor to see if all tissue has been removed, reducing the chance of uterine lining damage and future uterine adhesion
• Lower risk of complications

Who is suitable for this procedure for the treatment of early pregnancy miscarriage?

• Women with early pregnancy miscarriage (within 10 weeks of pregnancy)
• Women with incomplete miscarriage (miscarriage tissue not completely removed)
• Women with recurrent miscarriage
• Women undergoing assisted reproductive treatment (such as IUI and IVF) but experiencing repeated failures
• Women experiencing recurrent embryo implantation failure
• Women who want or are suggested to have genetic testing for their miscarriage

Who is not suitable for this treatment?

• Women with miscarriage >10 weeks of gestation
• Women with pregnancy of unknown origin
• Women with known narrowing of the cervical canal
• Women with multiple uterine fibroids
• Women with congenital uterine anomalies
• Women with pelvic infections

Procedure of Ultrasound-Guided Manual Vacuum Aspiration:

1. Appointment: The surgery is performed in an outpatient setting. You will be admitted to our day ward in the morning as a day case. You are also advised to fast for six hours before surgery.
2. Pre-operative preparation: Two to three hours before surgery, nurses will ask you to hold their urine to overflow their bladder and provide medication (Misoprostol) to soften the cervix and reduce cervical injury. During the surgery, anesthesiologists will provide monitored anesthesia for you, you will not experience pain during the procedure.
3. Surgery: The procedure takes around 10-15 minutes. You will be placed in the same position used for a routine gynaecology examination. The doctor will first insert a vaginal speculum into the vagina. If necessary, a small instrument may be used to help slightly dilate the cervix. Then, a narrow tube will be inserted through the cervix into the womb and remove the miscarriage tissue using a specially designed manual vacuum aspiration syringe. The entire process is performed under ultrasound guidance to reduce the chance of uterine lining damage and ensure all miscarriage tissue is removed. You will be discharged after 2-3 hours provided that you are well after the procedure.
4. Post-operative follow-up: A follow-up appointment will be given after the procedure to ensure that all of the miscarriage tissue has been removed.

Risks of the surgery:

Ultrasound-Guided Manual Vacuum Aspiration carries similar risks to traditional dilation and curettage (D&C) surgery and suction curettage, including vaginal bleeding, infection, uterine lining damage, cervical tear, and uterine perforation, but the chance of these risks occurring is low.

Post-operative precautions:

Ultrasound-Guided Manual Vacuum Aspiration is a minor surgical procedure. One to two weeks after surgery, women may experience slight irregular vaginal bleeding and mild menstrual cramps for several hours or even days. Doctors will prescribe pain relief medication upon discharge. If you have any severe vaginal bleeding with large amount of blood clots passed out, fever, severe abdominal pain or smelly vaginal discharge, please contact our staff for assistance promptly.

FAQ

Q: What is the success rate of Ultrasound-Guided Manual Vacuum Aspiration?

A: The success rate of USG-MVA in removing the miscarriage tissue is as high as 90%, similar to the success rate of traditional dilation and curettage (D&C) surgery.

Q: Will I experience any pain during the UGS-MVA procedure?

A: Doctors will provide monitored anesthesia, you will not feel pain during the procedure.

HEAL Fertility provides Ultrasound-Guided Manual Vacuum Aspiration services. Doctors will assess the patient's condition and provide appropriate treatment recommendations according to individual needs.