Surgical abortion using manual vacuum aspiration under local anaesthesia: a pilot study of feasibility and women's acceptability

Objective Studies from the USA have reported the efficacy and high acceptability of surgical abortion using manual vacuum aspiration (MVA) under local anaesthesia. The aim of this study was to assess the feasibility, acceptability and efficacy of surgical abortion using MVA under local anaesthesia for termination of pregnancy up to 63 days' gestation, within a UK National Health Service setting.

Methods Surgical abortion was carried out using MVA under local anaesthesia. Women's satisfaction with the procedure, and pain and anxiety levels, were assessed. The main outcome measures were: (1) feasibility assessed through successful completion of the procedure without the need for general anaesthetic or conversion to suction vacuum aspiration, (2) efficacy assessed through complete uterine evacuation without the need for further medical or surgical intervention and (3) women's acceptability of the procedure.

Results The mean (SD) gestation was 50 (9.4) days. A total of 55/56 (98%) women had a successful procedure and did not require any further surgical or medical treatment. Fifty-five (98%) women were satisfied with the procedure, 48 (86%) said they Would recommend it to a friend and 45 (80%) said they would have the same method again in the future. Anxiety levels, as reflected by the visual analogue scales, showed a significant fall in anxiety scores following the procedure (p < 0.01).

Conclusions Surgical abortion using MVA under local anaesthesia is effective and acceptable to women. These findings now need to be assessed in the context of a randomised trial.