Affiliation:
1. Senior Resident, Department of Obstetrics and Gynaecology, Patna Medical College and Hospital, Patna, Bihar, india.
Abstract
NICE guidelines published on 17 April 2019 recommended expectant management as 1 line advice in patients of 1 trimester miscarriage. So, this
study was done at department of obstetrics and Gynaecology, PMCH, Patna from June 2019 to May 2020 to see the uptake of expectant, medical
and surgical management in the patients and study the outcome of choices they made.
150 patients recruited after taking informed consent and allocated to three group according to their choice of management. Out of these 20 patients
in expectant group 9 patients turned up to surgical intervention. Out of 80 patients managed medically,10 needed surgical intervention after 14
days. In surgical managed group 1 required repeat check curettage. Expectant management was found to be more successful in patients with
incomplete abortion who were already in process of expulsion. Medical management was rst choice in women with early pregnancy loss less than
7 week, especially primigravidas, who had apprehension about future fertility. Surgical intervention was opted mostly by patients with ≥ 9 weeks
pregnancies and were most acceptive to recommendations for future pregnancies and also about contraception.
Satisfaction rate was highest in medical method group. Medical method was most popular among women and is a safe and effective choice. Women
were apprehensive about surgery and anaesthesia.
Expectant management is not opted by most women of Bihar.
No method is found superior above one to another in terms of outcome. Therefore, choice of women should be taken into consideration.