Patient preferences for expectant management vs. surgical evacuation in first-trimester uncomplicated miscarriage

Abstract

Objective: Expectant and surgical management are widely accepted treatment options in case of a miscarriage. In the absence of differences in complications, the choice between both options can be based on patient preferences.

Study design and setting: We studied treatment preferences for future miscarriages in women with a miscarriage randomized to expectant or surgical treatment or managed according to their own choice.

Results: Data from 136 patients were analyzed. Women randomized either to expectant or surgical management opted for the allocated treatment in future in 55 and 74%, respectively. Of the women randomized to expectant management and with a successful spontaneous loss, 71% opted again for this treatment. Women who were managed according to their own treatment choice, held on to their initial treatment preference (expectant vs. surgical management; 84 and 88%, respectively). Preferences after treatment were strong.

Conclusion: A strong treatment preference should be taken into account in the counseling process. Women without a preference should be well informed on all medical aspects of the two options in order to facilitate informed-shared decision-making.