Comparison of Expectant and Surgical Management of Incomplete First- Trimester Miscarriage
2013
Objective: To compare the maternal morbidity in terms of durations of hospital stay, duration of vaginal bleeding and presence of complications, following expectant management with surgical management of incomplete first-trimester miscarriage. Study Design: Quasi Experimental Study Place and duration: The study was conducted for one year and two months, from 20th December 2011 to 20th of February 2012, Department of Obstetrics and Gynecology, Bahawal Victoria Hospital, Bahawalpur. Materials and Methods: Total 150 cases were included in the study. They were divided into two groups each having 75 fulfilling the inclusion criteria. Group A had those who were managed expectantly and Group B comprised those having surgical evacuation of the uterus. Results: Mean hospital stay was 1.3 days in expectant and 1.5 days in surgical group. Bleeding lasted longer in expectant (10.1 days) than surgical group (7.3 days). Gynecological infections was diagnosed in 9 cases (6%), 3 cases (4%) in expectant and 6 (8%) in surgical group. Emergency evacuation was performed in 8% cases in expectant group against 4% cases in surgical group. 15 cases (20%) in expectant group failed to expel spontaneously compared to only 5 cases (6.6%) in surgical group. No mortality was observed in both groups. Conclusion: Expectant management is less efficient mode of treatment compared to surgical evacuation but can be an alternative to ERPC in women who are clinically stable and giving option for this treatment modality.
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