Original ArticlesTreatment of Miscarriage: Current Practice and Rationale
Section snippets
Materials and Methods
The data sources used in this study defined miscarriage varyingly, but in older literature, it usually meant an intrauterine pregnancy ending unintentionally in a loss before 28 weeks, and in the newer literature, it referred to a loss before 22 weeks. The following subgroups defined by Chamberlain[2]were identified whenever possible: inevitable miscarriage, both complete (all conceptional material is discharged spontaneously) and incomplete (evacuation has started or part of the material is
Treatment Practices
In the 1994 national survey, 326 of 2189 women (15%) reported that they had had one or more miscarriages. Table 1 shows the highest level of health care they had received, according to the year of the (latest) miscarriage. In all years, even when inspected by 5-year intervals, inpatient treatment was dominant, but in recent years, it has been somewhat rarer. Also, outpatient care was given more commonly in hospitals than in physicians’ offices outside hospitals. Only five (1.5%) women had not
Discussion
The different sources used in this study showed that in recent decades, the Finnish norm for treating miscarriage has been routine evacuation of the uterus in a hospital, regardless of the type of miscarriage. The need for professional care apparently has been self-evident for very long, because treatment recommendations did not mention it explicitly. The place of care is now changing from hospital wards to hospital outpatient care, and length of hospital stay is decreasing. It is unclear how
References (27)
- et al.
A comparison of manual vacuum aspiration (MVA) and sharp curettage in the management of incomplete abortion
Int J Gynaecol Obstet
(1994) - et al.
Management of missed abortion and fetal death in utero
Prostaglandins
(1977) - et al.
A time and cost analysis of the management of incomplete abortion with manual vacuum aspiration
Int J Gynaecol Obstet
(1994) - et al.
A review of the aggressive management of abortion
Am J Obstet Gynecol
(1958) Ultrasound diagnosis of complete abortion can reduce need for currettage
Eur J Obstet Gynecol Reprod Biol
(1992)- et al.
Recurrent miscarriage
Am J Perinatol
(1994) Vaginal bleeding in early pregnancy
BMJ
(1991)- et al.
Quality of contraceptive services in Finland
Qual Health Care
(1997) - et al.
Accuracy of data on diagnoses, procedures and accidents in the Finnish Hospital Discharge Register
Int J Health Sci
(1991) - et al.
Is ward evacuation for uncomplicated incomplete abortion under systemic analgesia safe and effective? A randomized clinical trial
S Afr Med J
(1994)
Aggressive management of incomplete abortion
Gen Practitioner
Curettage vs. nonsurgical management in women with early spontaneous abortions, the effect on fertility
J Reprod Med
Expectant management of first-trimester spontaneous abortion
Lancet
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