Expectant management for incomplete miscarriage

Traditionally, an incomplete miscarriage has been treated surgically with dilation and curettage (D&C). This practice is based on the concern that an incomplete miscarriage, in which a woman's uterus retains tissue, can lead to excessive bleeding or infection. Recent research, however, supports the use of close observation, called expectant management, as a treatment option for many early, uncomplicated miscarriages.¹

Expectant management may be a treatment choice for you if you:

• Are having a first-trimester miscarriage.
• Have stable blood pressure and a stable heart rate.
• Are not bleeding excessively and are not anemic.
• Do not have a fever or other signs of infection.
• Are not experiencing a high level of pain.
• Can keep frequent medical and blood work appointments during and after your miscarriage.

Expectant management requires regular monitoring by a health professional.²

Some women choose medical treatment or surgical treatment (D&C) instead of expectant management. Expectant management takes longer for the miscarriage to resolve and thus takes more time for bleeding to stop.

In some cases a miscarriage that is being treated with expectant management will still require surgical treatment, such as when excessive bleeding develops.

Citations

1. Geyman JP, et al. (1999). Expectant, medical, or surgical treatment of spontaneous abortion in first trimester of pregnancy? A pooled quantitative literature evaluation. Journal of the American Board of Family Practice, 12(1): 55–64.

2. Scroggins KM, et al. (2000). Spontaneous pregnancy loss. Primary Care, 27(1): 153–167.