Expectant management of first-trimester miscarriage

J Obstet Gynaecol. 2009 Nov;29(8):681-5. doi: 10.3109/01443610903215399.


Miscarriage is the most common complication of pregnancy, which creates a significant workload for health-care professionals. For decades, surgical evacuation of the uterus has remained the conventional treatment of first-trimester miscarriage. Recently, non surgical treatments have been introduced with increasing popularity. This review explores the evidence in support of expectant management of first-trimester miscarriage. It is safe, effective and well-tolerated by women. It enhances women's choice and control. It generates significant cost savings compared with the traditional surgical management. Accurate diagnosis, counselling, 24/7 telephone advice and follow-up are among the important aspects of expectant management. More studies are needed to develop methods for identifying miscarriages suitable for expectant management.

Publication types

  • Review

MeSH terms

  • Abortion, Spontaneous / economics
  • Abortion, Spontaneous / surgery
  • Abortion, Spontaneous / therapy*
  • Adult
  • Choice Behavior
  • Decision Making
  • Dilatation and Curettage / methods
  • Female
  • Humans
  • Patient Preference*
  • Patient Selection
  • Pelvic Infection / epidemiology
  • Pelvic Infection / prevention & control
  • Pregnancy
  • Pregnancy Trimester, First*
  • Risk Assessment