Spontaneous abortion rates after natural and assisted conception.

Steer, Charles M.; Campbell, Stuart; Davies, Melanie; Mason, B.; Collins, William P.

doi:10.1136/bmj.299.6711.1317

Cited by 48 publications

(20 citation statements)

References 3 publications

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“…The overall spontaneous miscarriage rates were 21% in this study [54] and 22% in another study [62]. This is not significantly different from the normal rate of 15% [63]. Even though there appears to be a higher incidence of vaginal bleeding in the first trimester in women with VWD, there is no increase in the miscarriage rate [54,59].…”

Section: Von Willebrand's Diseasecontrasting

confidence: 51%

The obstetric and gynaecological management of women with inherited bleeding disorders – review with guidelines produced by a taskforce of UK Haemophilia Centre Doctors’ Organization

et al. 2006

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Summary. The gynaecological and obstetric management of women with inherited coagulation disorders requires close collaboration between obstetrician/ gynaecologists and haematologists. Ideally these women should be managed in a joint disciplinary clinic where expertise and facilities are available to provide comprehensive assessment of the bleeding disorder and a combined plan of management. The haematologist should arrange and interpret laboratory tests and make provision for appropriate replacement therapy. These guidelines have been provided for healthcare professionals for information and guidance and it is also intended that they are readily available for women with bleeding disorders.

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Section: Von Willebrand's Diseasecontrasting

confidence: 51%

The obstetric and gynaecological management of women with inherited bleeding disorders – review with guidelines produced by a taskforce of UK Haemophilia Centre Doctors’ Organization

et al. 2006

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“…About 15% of women with a clinically recognised pregnancy will miscarry spontaneously during the first trimester 1. Current management often involves the surgical evacuation of retained products of conception even though serious complications—for example, infection, uterine perforation, or bowel damage—may arise 2.…”

Section: Introductionmentioning

confidence: 99%

Outcome of expectant management of spontaneous first trimester miscarriage: observational study

Luise

Jermy²,

May³

et al. 2002

BMJ

184

128

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Objectives To evaluate the uptake and outcome of expectant management of spontaneous first trimester miscarriage in an early pregnancy assessment unit. Participants 1096 consecutive patients with a diagnosis of spontaneous first trimester miscarriage. Methods Each miscarriage was classified as complete, incomplete, missed, or anembryonic on the basis of ultrasonography. Women who needed treatment were given the choice of expectant management or surgical evacuation of retained products of conception under general anaesthesia. Women undergoing expectant management were checked a few days after transvaginal bleeding had stopped, or they were monitored at weekly intervals for four weeks. Main outcome measures A complete miscarriage (absence of transvaginal bleeding and endometrial thickness < 15 mm), the number of women completing their miscarriage within each week of management, and complications (excessive pain or transvaginal bleeding necessitating hospital admission or clinical evidence of infection). Results Two patients with molar pregnancies were excluded, and 37% of the remainder (408/1094) were classified as having had a complete miscarriage. 70% (478/686) of women with retained products of conception chose expectant management; of these, 27 (6%) were lost to follow up. A successful outcome without surgical intervention was seen in 81% of cases (367/451). The rate of spontaneous completion was 91% (201/221) for those cases classified as incomplete miscarriage, 76% (105/138) for missed miscarriage, and 66% (61/92) for anembryonic pregnancy. 70% of women completed their miscarriage within 14 days of classification (84% for incomplete miscarriage and 52% for missed miscarriage and anembryonic pregnancy). Conclusions Most women with retained products of conception chose expectant management. Ultrasonography can be used to advise patients on the likelihood that their miscarriage will complete spontaneously within a given time.

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“…High miscarriage rates in the range of 20% to 30% have been consistently reported in infertile women, although only amongst those requiring direct ovarian stimulation using gonadotrophins either to induce ovulation or to stimulate multiple ovulation for assisted conception treatments (Shoham et al 1991). Some have argued that the rate only appears to be high due to unusually early recognition of pregnancy in these cases (Steer et al 1989), but study of equally closely monitored women undergoing donor insemination treatment because of azoospermia has shown a real difference in miscarriage rates: 29% vs 12% (Ransom et al 1993). Others have also shown that infertile women who ovulate normally or are enabled to ovulate normally (e.g., those who conceive naturally after tuba1 surgery, or by donor insemination treatment because of male infertility, or due to bromocriptine treatment to suppress hyperprolactinaemia) have low miscarriage rates: 11% to 12% (Jansen 1982).…”

Section: Miscarriagementioning

confidence: 99%

Complications of pregnancy after infertility treatment: awareness and prevention

Hull

1995

BJOG

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Spontaneous abortion rates after natural and assisted conception.

Cited by 48 publications

References 3 publications

The obstetric and gynaecological management of women with inherited bleeding disorders – review with guidelines produced by a taskforce of UK Haemophilia Centre Doctors’ Organization

The obstetric and gynaecological management of women with inherited bleeding disorders – review with guidelines produced by a taskforce of UK Haemophilia Centre Doctors’ Organization

Outcome of expectant management of spontaneous first trimester miscarriage: observational study

Complications of pregnancy after infertility treatment: awareness and prevention

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