Manual Vacuum Extraction

What is manual vacuum extraction?

With many miscarriages, women will experience bleeding and cramping and their bodies will spontaneously push out the tissue from the fetus or the placenta. When this does not happen, it is called a missed abortion. If the woman’s body starts the process but does not finish, it is called an incomplete abortion.

Manual vacuum extraction (MVE) is a procedure that is done when a woman has been diagnosed with a missed abortion or an incomplete abortion. MVE will empty the contents of the uterus and complete the miscarriage process.

Why is manual vacuum extraction done?

In some cases, women will request to have MVE performed in order to complete the miscarriage process more quickly. Bleeding is controlled and predictable and she can move forward immediately with the emotional healing that follows a miscarriage.

In other cases, women will elect to let nature take its course. In these cases, it is considered safe to wait a certain amount of time for the body to complete the miscarriage process. However, if the process takes too long there is an increased risk of an infection inside the uterus. When the process does not move along as expected, MVE may be suggested.

Is there anything I should do before the procedure?

• You will have blood work to determine your blood type. If you are Rh-Negative, you will need to get an injection of a medication called Rhogam. If you are Rh-Positive, no injection is needed.
• Your doctor will give you several prescriptions to take before the procedure. Some will be taken the night before, others will be taken the morning of the procedure.
• One of the medications you will be given is called Cytotec. Cytotec is a pill that you will insert into the vagina the night before your procedure. It will help soften your cervix and will make the procedure less painful.
• You will also be given a prescription for an antibiotic to take the morning of the MVE procedure. This will help to minimize your risk of infection.
• You will need to make arrangements to have someone drive you to and from your MVE procedure as the medications you will be given can make you groggy. You will be escorted to the car by a Women’s Health Center staff member and you will not be allowed to leave unless you have someone to drive you home.

What will happen during the procedure?

• Please eat a light meal. This is important because you will be given medication before the procedure that could cause stomach upset if you have not eaten.
• You will be taken to a special exam room to prepare for the procedure. Any friends or family that accompany you to the appointment will be asked to wait in the lobby until your procedure is finished. Please do not bring children to this appointment.
• Medications will be given to help with pain and to keep you relaxed.
• Your doctor will come into the exam room and put a catheter (a thin, flexible tube) into your uterus. This catheter is then attached to a suction device that will empty the contents of your uterus. The contents of the uterus will usually be sent to the hospital for pathologic study.
• You will be monitored for a while after the procedure to make sure you are not having heavy vaginal bleeding and that your pain is minimal.
• The MVE itself will take about 15 minutes, but you should plan on being here for a full 2 hours. That time will be used to prepare you for the procedure and to monitor you afterward.

What can I expect after the procedure?

• You will probably have some mild cramping for the rest of the day, which you can control with over-the counter medicine like Ibuprofen or Tylenol. Prescription pain medication may also be given by your doctor. Take the medications as instructed.
• Some women will have spotting or light bleeding. A watery vaginal discharge can also be common. Both the bleeding and discharge can last for 1-2 weeks.
• Your doctor will see you for a follow-up visit in about 2 weeks. The pathology report should be available at that time.
• You should not have intercourse until you have seen your doctor and have discussed any restrictions or suggestions for your next pregnancy attempt.
• Please remember that it is normal to feel grief, sadness, anger, guilt, or anxiety after a miscarriage. If these syptoms become severe or if you are having difficulty with daily activities because of your emotions, please call the office for an appointment. While normal, there are ways we can help you to cope.

You should call the office if…

• You develop a fever (a temperature of 100.4° Fahrenheit or higher).
• You have heavy vaginal bleeding (changing a maxi pad every 1-2 hours or more).
• You notice a strong odor to your vaginal discharge or if the discharge causes itching or irritation.
• You have sharp, severe pelvic pain in the first week after your MVE.