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.
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Three small randomised controlled trials have compared expectant management and surgical management of miscarriage.
“Three small randomised controlled trials have compared expectant management and surgical management of miscarriage.5-7”
From Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial) (2006) · cites this paper as [6]
The success rates in this trial were comparable to those in other trials of expectant management of incomplete miscarriage and early fetal demise.
“The success rates in this trial were comparable to those in other trials of expectant management of incomplete miscarriage and early fetal demise.6,7”
From Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial) (2006) · cites this paper as [6]
Expectant management resulted in complete uterine evacuation over three days in 79% of cases of incomplete miscarriage.
“Expectant management was found to result in complete uterine evacuation over three days in 79% of cases of incomplete miscarriage.6”
From Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial) (2006) · cites this paper as [6]
Cited by
Sorted by citations
Trinder, J., Brocklehurst, P., Porter, R., Read, M., Vyas, S., & Smith, L. (2006) · BMJ · doi:10.1136/bmj.38828.593125.55 · Cited by 299 · see citing works
Petrou, S., Trinder, J., Brocklehurst, P., & Smith, L. (2006) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2006.00998.x · Cited by 87 · see citing works
You, J. H. S., & Chung, T. K. H. (2005) · Human Reproduction · doi:10.1093/humrep/dei163 · Cited by 80 · see citing works
Petrou, S., & McIntosh, E. (2009) · Value in Health · doi:10.1111/j.1524-4733.2008.00459.x · Cited by 58 · see citing works
- Authors
- Nielsen, S., & Hahlin, M.
- Affiliations
- Sahlgrenska University Hospital (SE)
- Corresponding author
- Nielsen, S.
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1995-01
- Volume
- 345
- Issue
- 8942
- Pages
- 84-85
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2072652930
- Cited by
- 245
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 5 · 2019: 2 · 2018: 3 · 2017: 5 · 2016: 1 · 2015: 8 · 2014: 6 · 2013: 7 · 2012: 5
- FWCI
- 16.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- expectant management, miscarriage, first-trimester miscarriage, dilatation and curettage, transvaginal ultrasound, postoperative infection, postoperative anemia, convalescence
- MeSH terms
- Abortion, Spontaneous, Convalescence, Dilatation and Curettage, Female, Humans, Pregnancy, Pregnancy Trimester, First, Prospective Studies, Ultrasonography, Prenatal
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