Is curettage needed for uncomplicated incomplete spontaneous abortion?

S. A. Ballagh, H. A. Harris, K. Demasio

Research output: Contribution to journalArticle

50 Scopus citations

Abstract

Spontaneous abortion occurs in 15% to 20% of all human pregnancies. Since the late 1800s, the management of incomplete spontaneous abortion has focused on using curettage to empty the uterus as quickly as possible. This practice began to reduce blood loss and infection and has been unquestioned for 4 decades. In today's medical climate, few spontaneous abortions are the result of illegal manipulation, given the availability of legal pregnancy termination. Antibiotics and transfusions are-available, should complications arise in conservatively managed cases. Two prospective randomized trials suggest that conservative management may be advantageous for women who have stable vital signs without evidence of infection. They will have fewer perforations and, possibly, fewer infections and uterine synechiae with expectant or medical management. Larger trials should be undertaken to critically assess surgical evacuation compared to medical management, factoring in the psychologic impact of treatment. We believe that medical management will prove to be the most appropriate treatment for uncomplicated spontaneous incomplete abortion in the 21 st century.

Original languageEnglish (US)
Pages (from-to)1279-1282
Number of pages4
JournalAmerican Journal of Obstetrics and Gynecology
Volume179
Issue number5
DOIs
Publication statusPublished - Jan 1 1998
Externally publishedYes

    Fingerprint

Keywords

  • Incomplete abortion
  • Medical management
  • Miscarriage
  • Pregnancy complications
  • Septic abortion
  • Sharp curettage
  • Suction curettage

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this