Fertility after non-surgical management of the symptomatic first-trimester spontaneous abortion

Abstract

Aim: The aim of this study was to assess clinical outcome after a non-surgical management of the symptomatic spontaneous abortion in the first-trimester of pregnancy in a level III maternity hospital and to assess the subsequent fertility of the study population.

Methods: A prospective study in which 70 women with a symptomatic early pregnancy loss undergone an expectant management of miscarriage was performed. If resolution was not obtained after 4 days, medical treatment with misoprostol was administered. The patients were followed-up after the first menstrual cycle with a medical examination and an ultrasound scan. After 12 months, the patients were interviewed by phone to investigate on possible complications of abortion and on the occurrence of new pregnancies.

Results: The non-surgical management of miscarriage was successful in 68 out of 70 women (97%). Surgical intervention was necessary in 2 of 70 women (3%). Bleeding and pain were described as slightly more than a normal menstrual cycle. Among the 60 patients that answered at the 12-month follow-up (85.7%), none reported gynecological troubles and the subsequent pregnancy rate of the women was 81%.

Conclusion: Expectant management of selected cases of spontaneous abortion, associated to medical treatment in indicated cases, could offer a valid alternative to dilatation and curettage.