When you have been diagnosed with an incomplete or missed miscarriage you may be given options on how to proceed with the pregnancy. Some doctors will give you these three options:
- Expectant Management - do nothing and watch and wait to see what happens, hoping that a natural miscarriage will ensue without need for further intervention.
- Medical Management - use medications to help speed up the process of miscarriage.
- Surgical Management - to schedule a dilation and curettage (D and C) to clear the contents of the uterus and end the pregnancy surgically.
Previously physicians and midwives have had their preferences, as do the pregnant women involved. Though a new study has shown that the rates of complications like infection are extremely low (2-3%) but consistent among all types of care. The biggest difference was that there were more unexpected admissions and surgeries following the expectant and medical management.
This is not to say that you don't have a choice, just be well informed of what protocol you are undergoing and how you are being managed for your pregnancy loss. You should be able to have a discussion with your practitioner and have some say in what type of care you receive.
Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial)
BMJ 2006;332:1235-1240 (27 May).
Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial) BMJ 2006;332:1235-1240 (27 May).