Outcome of conservative management of incomplete 1st trimester miscarriage : observational study

Abstract EN

Background : the principle of emptying the uterus as quickly and safely as possible remains the corner stone of management of incomplete miscarriage.

In many countries surgical uterine evacuation is the standard treatment, expectant management has been advocated as an alternative in several observational studies.

Objectives : to evaluate the effectiveness of expectant management of incomplete 1st trimester miscarriage.

Study design and setting : Prospective observational study carried out at Babylon hospital for maternity and pediatrics between feb.2009-jan.

2010.

Materials and methods : the study involved 120 clinically stable patients with incomplete 1st trimester miscarriage (diagnosed by TVU), those patients subjected to conservative examination treatment (no intervention) and follow up for 2 weeks by clinical examination and transvaginal ultrasound.

The main outcome measures were complete miscarriage (absence of vaginal bleeding and endometrial thickness 15 mm by TVU), need for emergency curettage, infection and need for blood transfusion.

Result : successful outcome without surgical intervention was seen in of 85% of cases infection reported in 1.6% of cases, emergency curettage needed for 5 % (1.6% for infection and 3.3% for excessive vaginal bleeding), 10% of cases required elective surgical evacuation (4.1% of them refused follow up >1 week and 5.8% to failed to have complete miscarriage after 2 weeks of observation) without reported complications.

Conclusion : expectant management of clinically stable patients with retained product of conception.