2006 Apr 19;(2):CD003518. Expectant care versus surgical treatment for miscarriage. Family Health International, Clinical Research Department, PO Box 13950, Research Triangle Park, NC 27709, USA. knanda@fhi.org Miscarriage is a common complication of early pregnancy that can have both medical and psychological consequences like depression and anxiety. The need for routine surgical evacuation with miscarriage has been questioned because of potential complications such as cervical trauma, uterine perforation, hemorrhage, or infection.
To compare the safety and effectiveness of expectant management versus surgical treatment for early pregnancy loss. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (December 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2004, Issue 3), PubMed (1966 to March 2005), POPLINE (inception to March 2005), and LILACS (1982 to March 2005) and reference lists of reviews. Randomized trials comparing expectant care and surgical treatment (vacuum aspiration or dilation and curettage (D and C)) for miscarriage were eligible for inclusion. Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information.
Five trials were included in this review with 689 total participants. The expectant-care group was more likely to have an incomplete miscarriage (RR 5.37; 95% CI 2.57 to 11.22). However, the time frames for declaring the process incomplete varied across the studies. The need for unplanned surgical treatment (such as vacuum aspiration or DandC) was greater for the expectant-care group (RR 4.78; 95% CI 1.99 to 11.48). The expectant-care group had more days of bleeding (WMD 1.59; 95% CI 0.74 to 2.45) and a greater amount of bleeding (WMD 1.00; 95% CI 0.60 to 1.40). Post-procedure diagnosis of infection was lower in the expectant-care group (RR 0.29; 95% CI 0.09 to 0.87). Information on psychological outcomes and pregnancy was too limited to draw conclusions. Expectant management led to a higher risk of incomplete miscarriage, need for surgical emptying of the uterus, and bleeding. None of these were serious. In contrast, surgical evacuation was associated with a significantly higher risk of infection. Given the lack of clear superiority of either approach, the woman's preference should play a dominant role in decision making. Medical management has added choices for women and their clinicians, but these were not reviewed here.
Please click on the required question. Thank
you for choosing to visit us. This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT. I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
Cochrane Database Syst Rev.
Background:
Objectives:
Search Strategy:
Selection Criteria:
Data Collection And Analysis:
Main Results:
Conclusions:
- Introduction
- Abortion
- Amenorrhoea
- Birth Control
- Bladder Symptoms
- Cancer in Women
- Childbirth
- Children and Teenagers
- Diet / Weight Loss
- Dysmenorrhoea
- Endometriosis
- Fibroids
- HRT
- Hirsutism
- Hysterectomy
- Infections
- Infertility
- Medication Drugs
- Menopause
- Menorrhagia
- Miscarriage
- Definition
- Prevalence Prevalence
- Cause
- Symptoms
- Types of Miscarriage
- Spontaneous Miscarriage
- Threatened Miscarriage
- Treatment of Miscarriage
- Recurrent Miscarriage
- Miscarriage and Depression
- Ectopic Pregnancy
- Blighted Ovum
- Hydatidiform Mole
- Pregnancy Tests
- Pregnancy after Miscarriage
- Support Groups
- Painful Sex
- Pap Smear Test
- PCOS
- Pelvic Pain
- PMS
- Postpartum
- Pregnancy
- Self Esteem
- Sexual Problems
- Vaginal Discharge
- Vaginal Prolapse
- Vulval Symptoms
Underperforming Family Website?
Visit
KeywordSEOPro.com - SEO Keyword Tool & SEO Tips
Now
Promote Your
Family Website
Improve Your Business Income
