The natural course of spontaneous miscarriage: analysis of signs and symptoms in 188 expectantly managed women

Margreet Wieringa-de Waard, Willem M. Ankum, Gouke J. Bonsel, Jeroen Vos, Petra Biewenga, Patrick J. Bindels

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16 Citations (Scopus)

Abstract

Background: Expectant management is an alternative for curettage in women with a miscarriage Aim: To assess the pattern of vaginal bleeding and pain in expected women with a miscarriage, and to analyse the factantly managed women with a miscarriage, and to analyse the factors predictive of a relatively quick spontaneous loss of pregnancy Design of study: Part of a study comparing expectant management with surgical evacuation. Setting. Two hospitals in Amsterdam. method. in expectantly managed women with a miscarriage, the pattern of vaginal bleeding and pain and the probability of a spontaneous loss of pregnancy was analysed Results: of the 188 expectantly managed women 95 (51%) experienced a spontaneous loss of their pregnano In women with bleeding at inclusion, 52% had a completed miscarriage loss, while of the women without bleeding but with a coincidentally diagnosed non-viable pregnancy during routine ultrasonographic examination, 46% had a completed miscarriage. In the multivariate analysis an increasing bleeding pattern at inclusion was predictive of a relatively quick spontaneous loss of pregnancy. The median daily levels of bleeding and pain were the most prominent during the first 8 days after the start of the bleeding and decreased thereafter Conclusions: Expectant management is effective in 51% of unselected women with a miscarriage. An increasing bleeding pattern is predictive of a relatively quick spontaneous loss of pregnancy in first-trimester miscarriages. The graphical representation of our findings can he used to inform women about the natural course of miscarriages and a well-informed treatment choice
Original languageEnglish
Pages (from-to)704-708
JournalBritish journal of general practice
Volume53
Issue number494
Publication statusPublished - 2003

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