Is curettage needed for uncomplicated incomplete spontaneous abortion?

Ballagh, Susan A.; Harris, Heather A.; Demasio, Kafui

doi:10.1016/s0002-9378(98)70147-4

Cited by 65 publications

(35 citation statements)

References 17 publications

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“…1 Miscarriage can be managed surgically by evacuation of the uterus, medically with misoprostol, or expectantly by awaiting spontaneous expulsion of the failed pregnancy. [2][3][4][5] Many patients with early pregnancy loss are unwilling to undergo expectant management or misoprostol treatment, and, therefore, surgical management is performed. This can be accomplished with either manual vacuum aspiration (MVA) or electric vacuum aspiration (EVA).…”

Section: Introduction S Pontaneous and Missed Abortions Occur Inmentioning

confidence: 99%

Patient Acceptability of Manual Versus Electric Vacuum Aspiration for Early Pregnancy Loss

Edwards

Tureck

Fredrick

et al. 2007

Journal of Women's Health

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Section: Introduction S Pontaneous and Missed Abortions Occur Inmentioning

confidence: 99%

Patient Acceptability of Manual Versus Electric Vacuum Aspiration for Early Pregnancy Loss

Edwards

Tureck

Fredrick

et al. 2007

Journal of Women's Health

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“…In 4 of the 6 ectopic pregnancies that were missed, the uterus was thought to contain retained products of conception on TVS, including 2 where a gestational sac was erroneously identified. There is increasing interest in nonsurgical management of spontaneous abortions [11][12][13]. However, with this approach, delays in the correct diagnosis of ectopic pregnancies may occur, because there are no uterine curettings to examine.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Clinical Diagnostic Methods of Threatened Abortion

Yip

Sahota

Cheung

et al. 2003

Gynecol Obstet Invest

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Objective: To examine the accuracy of clinical diagnostic methods in assessing vaginal bleeding in pregnant women before 28 weeks’ gestation. Methods: 772 consecutive women who presented with threatened abortion before 28 weeks’ gestation were studied. Structured history and physical examination were performed on each woman as initial clinical assessment. This was followed by transvaginal sonography to determine the status of pregnancy. The accuracy of diagnoses at different clinical stages (history, physical examination, and transvaginal sonography) relative to the final diagnosis was compared using the kappa coefficient (ĸ). Results: Clinicians were unable to accurately diagnose or predict the status of the pregnancy from history alone (ĸ = 0.33; 95% CI 0.28, 0.38) or after physical examination (ĸ = 0.57; 95% CI 0.52, 0.62). Transvaginal sonography led to an accurate diagnosis of pregnancy status (ĸ = 0.96; 95% CI 0.95, 0.98) in most cases, except where an ectopic pregnancy existed. Absence of abdominal tenderness (p = 0.04), cervical excitation (p = 0.02), and incorrect identification of retained products of conception on transvaginal sonography (p = 0.01) were features of missed ectopic pregnancy. Conclusions: The clinical assessment of threatened abortion by history and physical examination is unreliable in most cases. The diagnostic accuracy is improved by the addition of transvaginal sonography. Even with the help of transvaginal sonography, a small proportion of ectopic pregnancies will be missed.

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“…Ainsi, la méthode la moins invasive est à préférer pour limiter l'incidence des synéchies [11,12,94,95]. Les rétentions après avortement ou fausse couche incomplète peuvent être prises en charge par hystéroscopie sans résection électrique ce qui semble diminuer le taux de synéchies et améliorer le taux de grossesse par rapport à un curetage échoguidé [96].…”

Section: Prévention Au Cours Du Geste Chirurgicalunclassified