Threatened miscarriage: evaluation and management
Journal
British Journal of Medicine and Medical Research
Date Issued
July 15, 2004
DOI
10.1136/bmj.329.7458.152
Abstract
Threatened miscarriage—vaginal bleeding before 20
gestational weeks—is the commonest complication in
pregnancy, occurring in about a fifth of cases.w1 Miscarriage
is 2.6 times as likely,1 and 17% of cases are
expected to present complications later in pregnancy.2
Although general practitioners and gynaecologists
often see this condition, management of threatened
miscarriage is mostly empirical. Bed rest is routinely
recommended, and about a third of women presenting
with threatened miscarriage are prescribed drugs.w2
However, two thirds of the general practitioners
recommending this do not believe it affects outcome.3
In this review, we present available evidence on the
initial evaluation and management of threatened
miscarriage, focusing mainly on the first trimester of
pregnancy and primary healthcare settings.
gestational weeks—is the commonest complication in
pregnancy, occurring in about a fifth of cases.w1 Miscarriage
is 2.6 times as likely,1 and 17% of cases are
expected to present complications later in pregnancy.2
Although general practitioners and gynaecologists
often see this condition, management of threatened
miscarriage is mostly empirical. Bed rest is routinely
recommended, and about a third of women presenting
with threatened miscarriage are prescribed drugs.w2
However, two thirds of the general practitioners
recommending this do not believe it affects outcome.3
In this review, we present available evidence on the
initial evaluation and management of threatened
miscarriage, focusing mainly on the first trimester of
pregnancy and primary healthcare settings.