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.
Pregnancy Complications ; Abortion, Spontaneous

Introduction: Secure attachment to parents prevents adolescents from externalizingbehaviours especially in developing countries. The aim of this study was to identify thecontributors to parental attachment in a developing society. Methodology: This crosssectional study was performed on urban secondary students (aged between 13 and 17 years)based on multistage sampling in Pasir Gudang District, Johor, Malaysia. The depression,anxiety and stress (DASS-21) and Inventory of parent and peer attachment (IPPA)questionnaires were used along with a questionnaire for demographic information. Analysisof covariance (ANCOVA) was used to identify the main effect of study parameters on IPPAscores for father and mother. Results: A total of 2980 students (46.9% male and 53.1%female) participated in this study. Mean and SD for age was 14.39±1.28. Depression scoreand school form had a significant main effect on both paternal and maternal attachment(p<0.05). Age (p=0.003), ethnicity (p=0.01), history of intimate relationship (p=0.03),paternal education level (p=0.006) and maternal education level (p=0.04) had a main effecton paternal attachment, while gender (p=0.02) and stress (p=0.001) were shown to havesignificant main effect on maternal attachment. Discussion: The findings of this studyrevealed different contributors for adolescent attachment with father and mother. Local,cultural and economic structure of the community should be taken into account in order toplan for an intervention strategy to secure adolescent’s relationship with parents.