The Incidence of Unplanned Curettage in Expectant versus Medical and Surgical Management of Spontaneous First Trimester Abortion

Abstract

here are various options available to manage early pregnancy miscarriages; surgical, medical and expectant management. Traditionally, surgical curettage has been performed following the diagnosis of miscarriage, on the assumption that this prevents haemorrhage and decreases the risk of subsequent gynaecological infection, however; surgical management complications include infection, uterine perforation or bowel damage. Applying non-surgical intervention management (expectant and medical) are preferred because of the avoidance of general anaesthesia and invasive surgery but some researchers found disadvantages include unpredictable outcome, pain, and the risk of subsequent gynaecological infection. The optimal mode for management of spontaneous first trimester pregnancy loss is usually determined by medical opinion and patient preference. The aim of our study was to compare and assess the incidence of unplanned uterine curettage between expectant management versus medical and surgical management within of first trimester missed and incomplete miscarriage. This Randomized controlled trial included 150 patients diagnosed with early fetal demise at less than 13 weeks’ gestation. They were recruited and assessed for eligibility from Ain Shams University Maternity Hospital. Cases were randomized according to a computer-generated random sequence into three groups; Expectant, Surgical and Medical groups.