According to WHO 2022 abortion care guidelines, what is the recommended vacuum aspiration method for first-trimester MTP up to 14 weeks?
- A Sharp curettage (D&C) is equally recommended up to 12 weeks
- B MVA or EVA is acceptable up to 14 weeks; sharp curettage is not recommended for routine first-trimester MTP ✓
- C Manual vacuum aspiration (MVA) up to 12 weeks; electric vacuum aspiration (EVA) for 12–14 weeks
- D Electric vacuum aspiration (EVA) only, as MVA is not adequate beyond 10 weeks
Correct answer: B. MVA or EVA is acceptable up to 14 weeks; sharp curettage is not recommended for routine first-trimester MTP
Explanation
WHO 2022 updated guidelines recommend vacuum aspiration (manual or electric) as the gold-standard method for surgical abortion up to 14 weeks. Both MVA and EVA are effective and safe up to 14 weeks gestational age. Sharp curettage (D&C) carries higher complication risk (perforation, haemorrhage, Asherman syndrome) and is explicitly NOT recommended by WHO for routine first-trimester surgical MTP. This represents a guideline update from earlier WHO editions.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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