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Many women request surgical abortion before 6 weeks' gestation, yet one third of abortion providers do not perform surgical abortion this early because of concern that the procedure may fail, resulting in an ongoing pregnancy. Two options are available for surgical abortion before 6 weeks: manual vacuum aspiration (MVA; suction is generated with a large syringe) and electric vacuum aspiration (EVA; suction is generated with a motorized device).
In a recent clinical trial, 498 women with pregnancies <6 weeks' gestation who requested surgical abortions were randomized to MVA or EVA. Among 438 evaluable women, only 7 (1.6%) had an ongoing pregnancy after abortion. Ongoing pregnancy was diagnosed in five women (2.3%) in the MVA group and two (1%…