Problems with the MVA

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HealthWiki > A Book for Midwives > Chapter 23: Manual vacuum aspiration (MVA) > Problems with the MVA

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In this chapter:

 

In this chapter:

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.

Solution:

1. Take the syringe off of the cannula.
2. Empty the syringe.
3. Put a new, sterilized cannula into the womb.

4. Make 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. Open the valves by pushing the button toward yourself to continue emptying the womb.

The syringe is full

When the syringe is mostly full, it will not have enough vacuum to empty the rest of the tissue out of the womb.

Solution:

1. Take the syringe off of the cannula, leaving the cannula in the womb.
2. Empty the syringe.
3. Make a new vacuum in the syringe: Push the button down and in to close the valve, and pull back the arms until they snap out at the end of the syringe barrel.
4. Gently attach the cannula to the syringe again.
5. Open the valve by pushing the button toward yourself to continue emptying the womb.

The cannula becomes clogged

Solution:

1. Remove the syringe and cannula from the womb and take the syringe off of the cannula.
2. Empty the syringe.
   
3. Put a new, sterilized cannula into the womb. You may need a larger-sized cannula.

4. Make 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. Open the valve by pushing the button toward yourself to continue emptying the womb.

Sometimes there is a piece of tissue stuck in the cervix that continues to clog the cannula. You may be able to remove it with a pair of sterilized forceps.

The womb is too big to empty using MVA

Sometimes you may think that a woman’s womb is small enough to do MVA, but after you start the MVA, you find out that it is too large. She may think she became pregnant later than she actually did. Or her womb may have felt smaller than it really was.

Solution:

If you start to do an MVA, but you cannot empty the womb all the way, first try using a larger cannula. But if you still cannot empty the womb, you must find someone else to empty her womb right away. Even if you must go to a distant hospital, you must get help. She is in serious danger.

You may also:

• give misoprostol to empty the womb.
• watch for signs of infection.

Problems that MVA can cause

MVA can cause problems if it is done incorrectly. Even experienced midwives will sometimes see problems after MVA. The most common problems are:

• incomplete MVA.
• infection.
• injury to the womb.

This page was updated:01 Mar 2024