Expectant management of first-trimester spontaneous abortion.

Abstract

Approximately 15% of registered pregnancies end in spontaneous abortion, and for 50 years or so dilatation and curettage (D&C) has been the usual management. In a prospective randomised trial we compared the clinical results after either expectant management or D&C, for miscarriages of less than 13 weeks' gestation in which transvaginal ultrasound examination showed intrauterine tissue and/or blood clots with a diameter 15-50 mm. 103 patients were randomised to expectant management and spontaneous resolution of pregnancy occurred within 3 days in 81 cases (79%). 52 patients were randomised to D&C. 3 infections were diagnosed among patients who underwent expectant management (3%); 5 infections and 1 case of postoperative anaemia were observed among patients randomised to D&C (11%). The duration of vaginal bleeding was a mean of 1.3 days longer in the expectant management group (p < 0.02). Convalescence time, time during which patients experienced pain, and packed-cell volume 3 and 14 days after inclusion did not differ significantly between the groups. This study shows that expectant management of selected cases of spontaneous abortion has a similar outcome to D&C.

• Authors: S Nielsen, M Hahlin
• Journal: Lancet (London, England) (Lancet) Vol. 345 Issue 8942 Pg. 84-6 (Jan 14 1995) ISSN: 0140-6736 [Print] England
• PMID: 7815886 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Abortion, Spontaneous (complications, diagnostic imaging, therapy)
• Convalescence
• Dilatation and Curettage (adverse effects)
• Female
• Humans
• Pregnancy
• Pregnancy Trimester, First
• Prospective Studies
• Ultrasonography, Prenatal