Expectant management of incomplete miscarriage, anembryonic pregnancy and early fetal demise: a comparative study

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dc.contributor.authorK., Reshma Sajan K.en_US
dc.contributor.authorP., Mumtazen_US
dc.contributor.authorV., Chandrika C.en_US
dc.contributor.authorVahab, Abdulen_US
dc.contributor.authorImrana, Hassan Sheikhen_US
dc.date.accessioned2020-10-16T08:06:30Z
dc.date.available2020-10-16T08:06:30Z
dc.date.issued2020-08
dc.description.abstractBackground: Expectant management as first line management of early pregnancy miscarriages is less accepted due to failure and increased complications reported in few studies. Proper selection of cases improves outcome of expectant management. Aim of this study was to compare success rate and complications in expectant management in three groups of early pregnancy miscarriages- Incomplete miscarriage, anembryonic pregnancy and early fetal demise.Methods: Prospective observational study conducted in tertiary care centre for 3 years, including 107 patients with USG confirmed pregnancy miscarriage <13 weeks. Patients preferring expectant management were managed as outpatient without intervention for 2 weeks after which repeat USG was done to ascertain complete miscarriage. Failed expectant management patients underwent planned surgical uterine evacuation. Emergency admission and evacuation was done, if symptomatic during waiting period. Success rate and complications like emergency evacuation, vaginal bleeding, abdominal pain, limitation of physical activity and patient satisfaction were assessed and compared in subgroups of anembryonic pregnancy, early fetal demise and incomplete miscarriage. Statistical analysis was done by chi-square test.Results: Incomplete miscarriage group had highest success rate of 88.46%. followed by anembryonic pregnancy (72.5%) and EFD (47.83%) p value = 0.007. Complication rate was highest in EFD, followed by anembryonic and the least in incomplete miscarriage all of which was statistically significant except vaginal bleeding.Conclusions: Expectant management should be offered as first line choice for all types of early pregnancy miscarriages. Proper selection of case as to type of miscarriage especially incomplete miscarriage and selected cases of anembryonic pregnancy and EFD ensures higher success rate with lesser complications. Reserving medical and surgical management for unsuitable/failed cases.en_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynecology, Government Medical College, Palakkad, Kerala, Indiaen_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynecology, MES Medical College, Perintalmanna, Kerala, Indiaen_US
dc.identifier.citationK. Reshma Sajan K., P. Mumtaz, V. Chandrika C., Vahab Abdul, Imrana Hassan Sheikh. Expectant management of incomplete miscarriage, anembryonic pregnancy and early fetal demise: a comparative study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2020 Aug; 9(8): 3144-3150en_US
dc.identifier.issn2320-1770
dc.identifier.issn2320-1789
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/207971
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber8en_US
dc.relation.volume9en_US
dc.source.urihttps://dx.doi.org/10.18203/2320-1770.ijrcog20203100en_US
dc.subjectAnembryonic pregnancyen_US
dc.subjectEarly fetal demiseen_US
dc.subjectEarly pregnancy miscarriageen_US
dc.subjectExpectant managementen_US
dc.subjectIncomplete miscarriageen_US
dc.titleExpectant management of incomplete miscarriage, anembryonic pregnancy and early fetal demise: a comparative studyen_US
dc.typeJournal Articleen_US
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