Chapter 23: Manual vacuum aspiration (MVA)
19. Look at the tissue from the womb to see if it is complete.
It is important to know if you have removed all the
tissue, because if any is left inside the womb it can
cause infection and bleeding.
Pour the tissue through a sieve or add some clean water to
the jar it is in. What you see will depend on why the woman
needed the MVA.
If the woman had an MVA to end a pregnancy or because she
was bleeding from a miscarriage, you should see the complete
pregnancy. After 4 weeks of pregnancy, there should be white
or yellowish feathery tissue attached to a small, clear sac. If you
do not see all this material, repeat the MVA.
If you are doing an MVA to empty the womb after an incomplete abortion or
incomplete miscarriage, you might not see all of this tissue. Some of it may
have already passed out of the womb. Take note of what you see anyway.
If you did not see the complete pregnancy tissue when you did the MVA, and
the woman has bleeding or signs of infection later, you should repeat the
20. Use the suggestions on page 67 to 69 to safely dispose of the bloody tissue.
Problems with the MVA
There are some problems that can happen during MVA that will prevent the
MVA from being complete. You must solve them to finish the MVA and to
protect the woman from bleeding or becoming ill after the MVA.
The cannula comes out of the womb
If the tip of the cannula comes out of the womb after the valve has been opened,
even if it comes out just a little, the vacuum will be lost. The syringe will not be
able to remove any more tissue.
1. Take the syringe off of the cannula.
2. Empty the syringe.
3. Put a new, sterilized cannula into the womb.
4. M ake a new vacuum in the syringe — push the button down
and forward to close the valve, and pull back the arms until
they snap out at the end of the syringe barrel.
5. Gently attach the cannula to the syringe.
6. O pen the valve by pushing the button toward yourself to
continue emptying the womb.
A Book for Midwives (2010)