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ABSTRACT: Background
Expectant management is an alternative for curettage in women with a miscarriage.Aim
To assess the pattern of vaginal bleeding and pain in expectantly managed women with a miscarriage, and to analyse the factors predictive of a relatively quick spontaneous loss of pregnancy.Design of study
Part of a study comparing expectant management with surgical evacuation.Setting
Two hospitals in Amsterdam.Method
In expectantly managed women with a miscarriage, the pattern of vaginal bleeding and pain and the probability of a spontaneous loss of pregnancy was analysed.Results
Of the 188 expectantly managed women 95 (51%) experienced a spontaneous loss of their pregnancy. In women with bleeding at inclusion, 52% had a completed miscarriage loss, while of the women without bleeding but with a coincidentally diagnosed non-viable pregnancy during routine ultrasonographic examination, 46% had a completed miscarriage. In the multivariate analysis an increasing bleeding pattern at inclusion was predictive of a relatively quick spontaneous loss of pregnancy. The median daily levels of bleeding and pain were the most prominent during the first 8 days after the start of the bleeding and decreased thereafter.Conclusions
Expectant management is effective in 51% of unselected women with a miscarriage. An increasing bleeding pattern is predictive of a relatively quick spontaneous loss of pregnancy in first-trimester miscarriages. The graphical representation of our findings can be used to inform women about the natural course of miscarriages and a well-informed treatment choice.
SUBMITTER: Wieringa-de Waard M
PROVIDER: S-EPMC1314693 | biostudies-literature | 2003 Sep
REPOSITORIES: biostudies-literature
The British journal of general practice : the journal of the Royal College of General Practitioners 20030901 494
<h4>Background</h4>Expectant management is an alternative for curettage in women with a miscarriage.<h4>Aim</h4>To assess the pattern of vaginal bleeding and pain in expectantly managed women with a miscarriage, and to analyse the factors predictive of a relatively quick spontaneous loss of pregnancy.<h4>Design of study</h4>Part of a study comparing expectant management with surgical evacuation.<h4>Setting</h4>Two hospitals in Amsterdam.<h4>Method</h4>In expectantly managed women with a miscarri ...[more]