| July 2006 · Vol. 18, No. 7 OBSTETRICS
Managing miscarriage: How the options stack up
Surgery is no longer the only choice, though some women may prefer it
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Fast Track
Vacuum aspiration is superior to sharp curettage in terms of blood loss, pain, and duration of the procedure
The risk of complications with expectant management increases with the amount of intrauterine tissue
84–88% of women managed with their choice of treatments maintained a favorable opinion of that choice, vs 55–74% of women who accepted randomization
Offer medical and expectant management only if the patient has access to round-the-clock telephone advice and immediate hospitalization, if required
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Alexandros
Sotiriadis,
MDSpecialist ObGyn and Research Fellow, Department of Obstetrics and Gynecology, University Hospital of Ioannina, Greece
CASE Can surgery be avoided for incomplete miscarriage?
“G.A.” is a 34-year-old gravida 3, para 1 who presents to the emergency room at 9 weeks’ gestation complaining of vaginal bleeding and cramping that began the night before. A transvaginal scan and speculum examination reveal minimal cervical dilatation with expulsion of a small quantity of gestational tissue, with most of the conceptus still inside the uterus.
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