Document Detail

Expectant management versus elective curettage for the treatment of spontaneous abortion.
MedLine Citation:
PMID:  9341597     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether the amount of intrauterine tissue was prognostic of the risk of complications associated with the management of nonviable pregnancies diagnosed in the first trimester before cervical dilatation (termed here impending abortion) with either expectant observation or elective curettage. DESIGN: Historic cohort study. SETTING: University Infertility Service. PATIENT(S): All women with nonviable pregnancies followed by the Division of Reproductive Endocrinology during a 5-year period. The patients were divided into those with significant intrauterine tissue (gestational sac > 10 mm) and those with minimal intrauterine tissue. INTERVENTION(S): Women either underwent elective curettage or were followed expectantly. MAIN OUTCOME MEASURE(S): Complication rates. RESULT(S): In 89 women with minimal tissue, no complications occurred regardless of treatment mode. In 63 women with significant intrauterine tissue, expectant management resulted in more complications (9/24) than elective curettage (1/39). In the expectant group, complications included missed abortion, septic abortion, and incomplete abortion requiring emergency curettage, with one patient requiring a transfusion. In the curettage group one uterine perforation occurred. CONCLUSION(S): In women with impending abortions and minimal intrauterine tissue, expectant treatment is safe after ectopic pregnancy has been excluded. In patients with significant intrauterine tissue, the risk of complications may be decreased by elective uterine curettage compared with expectant management.
W W Hurd; R R Whitfield; J F Randolph; M L Kercher
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Fertility and sterility     Volume:  68     ISSN:  0015-0282     ISO Abbreviation:  Fertil. Steril.     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-11-19     Completed Date:  1997-11-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  601-6     Citation Subset:  IM    
Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, USA.
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MeSH Terms
Abortion, Threatened / therapy*,  ultrasonography
Cohort Studies
Postoperative Complications
Pregnancy Complications
Pregnancy Trimester, First
Ultrasonography, Prenatal

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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