European Journal of Cardiovascular Medicine

Background:The goal of the current study was to evaluate the effectiveness, safety, acceptability, and degree of satisfaction of medical method vs manual vacuum aspiration (MVA) in first-trimester pregnancies with clinically confirmed missed miscarriages.Methods: From January 2021 to December 2022, a comparative interventional study on 100 clinically diagnosed first trimester missed miscarriages of gestational ages less than 12 weeks pog was undertaken at the Department of Obstetrics & Gynecology, Guntur Medical College, Guntur. Group A consisted of 50 patients who chose the medical procedure, and group B consisted of 50 patients who chose manual vacuum aspiration.Results:The mean age of the patients in MVA group was 23.6 and in the medical management group was 24.6. The mean gestational age was 67.5 days for the MVA group and 70.1 days for the MM group. The median value differences of Gravida, Para, Live and abortions between both the groups is not significant. The difference in pallor before intervention in both the groups is not significant at p>0.05. The difference in blood loss between both the groups is significant at p value <0.05. There is a significant amount of blood loss in medical management group compared to MVA group. The difference in both the groups for efficacy in terms of retained products of contraception during TVS/TAS scan is significant at p <0.05. MVA is better than medical management in terms of efficacy in managing missed abortions. The difference between the duration of hospital stay between both the groups is significant at p-value <0.05. The duration of hospital stay with MVA is shorter than with medical methods. The difference in pain by VAS is statistically significant between both the groups at p<0.0001. Pain according to Visual Analogue Score is more in medical management compared to MVA group. Patient satisfaction is more in MVA group compared to medical management group.Conclusions: Comparing the medical approach to MVA method, there is more bleeding per vaginum; this implies safety. Less patients left AMA/absconded, which led to a high satisfaction percentage in the MVA group. Because there were more cases of complete evacuation in the MVA group, the MVA mode of abortion in the current study was more effective. Due to shorter hospital stay, the MVA group had a higher patient acceptability rate than the medical group. The MVA is thereby demonstrated to be a more effective, safe, acceptable, and satisfying method than medical management.