Expectant Management of Missed Miscarriage
- Author:
Andi Anggeriana Andi Asri
;
Noor Azmi Mat Adenan
;
Ali Jafarzadeh Esfehani
;
Norhafizah Mohtaruddin
;
Ma Saung Oo
;
Latiffah A. Latiff
- Publication Type:Journal Article
- Keywords:
Expectant missed miscarriage;
Safety;
Management
- MeSH:
Pregnancy Complications;
Abortion, Spontaneous
- From:Malaysian Journal of Medicine and Health Sciences
2015;11(1):69-76
- CountryMalaysia
- Language:English
-
Abstract:
Early pregnancy losses occur in 10-20% of all pregnancies. Surgical evacuation has always been the
mainstay of management of miscarriages. The main aim of this study was to understand the success rate
of expectant management of miscarriage with regards to gestational sac size and period of gestation.
The secondary outcome was to measure the satisfaction level and the rate of pregnancy after 6 month of
expectant management. Patients diagnosed with missed miscarriages were requested to choose between
expectant or surgical management. Those decided for expectant management on “wait and watch”
approach were assessed weekly up to 5 completed weeks until complete miscarriage was achieved
spontaneously. Surgical evacuation was performed if medically indicated or requested by the patients
at any time or at the end of fifth week if complete miscarriage was not achieved. Out of 212 cases, 75
(35.4%) opted for expectant management. Complete miscarriage was achieved in 85.3% of subjects by
the end of fifth weeks respectively. Mean of Gestational sac size and period of gestation was not found
to influence the success rate of complete spontaneous miscarriage in the expectant management. No
morbidity was recorded during the five weeks of the study period. Mean satisfaction score was 9.7±8.3.
Pregnancy occurred in 47% of patients within 6 months follow up. The Receiver operation characteristic
(ROC) curve analysis suggested the end of second week as the cut off for surgical intervention. This
study revealed that expectant management of missed miscarriage is a reliable management of missed
miscarriage within the first two weeks.
- Full text:P020150604459789823510.pdf
