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management of incomplete miscarriage

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https://www.readbyqxmd.com/read/27591236/misorest-surgical-versus-expectant-management-in-women-with-an-incomplete-evacuation-of-the-uterus-after-misoprostol-treatment-for-miscarriage-a-randomized-controlled-trial
#1
M Lemmers, M A C Verschoor, K Oude Rengerink, C Naaktgeboren, B C Opmeer, P M Bossuyt, J A F Huirne, C A H Janssen, C Radder, E R Klinkert, J Langenveld, R Catshoek, L Van der Voet, F Siemens, P Geomini, M H Van Hooff, J M Van der Ploeg, S F P J Coppus, W M Ankum, B W J Mol
STUDY QUESTION: Is curettage more effective than expectant management in case of an incomplete evacuation after misoprostol treatment for first trimester miscarriage? SUMMARY ANSWER: Curettage leads to a higher chance of complete evacuation but expectant management is successful in at least 76% of women with an incomplete evacuation of the uterus after misoprostol treatment for first trimester miscarriage. WHAT IS KNOWN ALREADY: In 5-50% of the women treated with misoprostol, there is a suspicion of incomplete evacuation of the uterus on sonography...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27039249/pregnancy-loss-french-clinical-practice-guidelines
#2
EDITORIAL
C Huchon, X Deffieux, G Beucher, P Capmas, X Carcopino, N Costedoat-Chalumeau, A Delabaere, V Gallot, E Iraola, V Lavoue, G Legendre, V Lejeune-Saada, J Leveque, S Nedellec, J Nizard, T Quibel, D Subtil, F Vialard, D Lemery
In intrauterine pregnancies of uncertain viability with a gestational sac without a yolk sac (with a mean of three orthogonal transvaginal ultrasound measurements <25mm), the suspected pregnancy loss should only be confirmed after a follow-up scan at least 14 days later shows no embryo with cardiac activity (Grade C). In intrauterine pregnancies of uncertain viability with an embryo <7mm on transvaginal ultrasound, the suspected pregnancy loss should only be confirmed after a follow-up scan at least 7 days later (Grade C)...
June 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/26629383/effectiveness-of-misoprostol-for-induction-of-first-trimester-miscarriages-experience-at-a-single-tertiary-care-centre-in-oman
#3
Qamariya Ambusaidi, Anita Zutshi
OBJECTIVES: Non-invasive methods of inducing a miscarriage are now considered an effective alternative to surgical evacuation (dilatation and curettage). This study aimed to evaluate the effectiveness of misoprostol in the termination of first-trimester miscarriages. METHODS: This prospective study was conducted between October 2009 and September 2010 and assessed all patients admitted to the Royal Hospital in Muscat, Oman, for the termination of first-trimester miscarriages during the study period...
November 2015: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/26453977/long-term-complications-and-reproductive-outcome-after-the-management-of-retained-products-of-conception-a-systematic-review
#4
REVIEW
Angelo B Hooker, Humeyra Aydin, Hans A M Brölmann, Judith A F Huirne
OBJECTIVE: To examine the long-term complications and reproductive outcomes after the management of retained products of conception (RPOC). DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): Women suspected of RPOC who were subjected to medical therapy with misoprostol or surgical treatment. INTERVENTION(S): An electronic literature search was conducted in June 2015 using MEDLINE, EMBASE, and the Cochrane library...
January 2016: Fertility and Sterility
https://www.readbyqxmd.com/read/26094338/-recent-recommendations-in-the-management-of-early-pregnancy-failure
#5
REVIEW
Aleksandra Stupak, Anna Kwaśniewska
Spontaneous abortion refers to pregnancy loss up to the end of 22 weeks' (21(+7)) gestation. Currently, the terminology suggests early pregnancy loss or early pregnancy failure. Miscarriage occurs in 10-20% of pregnancies, and most of them take place up to 13 weeks'gestation. Management in the case of vaginal bleeding in women with a confirmed pregnancy requires a physical examination (with a speculum), and a biochemical and ultrasound diagnosis. Conservative, pharmacological or surgical management can be offered to patients with an incomplete miscarriage...
2015: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/25886596/an-audit-of-the-initial-resuscitation-of-severely-ill-patients-presenting-with-septic-incomplete-miscarriages-at-a-tertiary-hospital-in-south-africa
#6
Hennie Lombaard, Sumaiya Adam, Jennifer Makin, Patricia Sebola
BACKGROUND: Septic incomplete miscarriages remain a cause of maternal deaths in South Africa. There was an initial decline in mortality when a strict protocol based approach and the Choice of Termination of Pregnancy Act in South Africa were implemented in this country. However, a recent unpublished audit at the Pretoria Academic Complex (Kalafong and Steve Biko Academic Hospitals) suggested that maternal mortality due to this condition is increasing. The objective of this investigation is to do a retrospective audit with the purpose of identifying the reasons for the deteriorating mortality index attributed to septic incomplete miscarriage at Steve Biko Academic Hospital...
2015: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/25879688/uterine-artery-doppler-in-the-management-of-early-pregnancy-loss-a-prospective-longitudinal-study
#7
Luís Guedes-Martins, Joaquim P Saraiva, Ana R Gaio, Ana Reynolds, Filipe Macedo, Henrique Almeida
BACKGROUND: The pharmacological management of early pregnancy loss reduced substantially the need for dilation and curettage. However, prognostic markers of successful outcome were not established. Thus the major purpose of this study was to determine the sensitivity and specificity of the uterine artery pulsatility (PI) and resistance (RI) indices to detect early pregnancy loss patients requiring dilation and curettage after unsuccessful management. METHODS: A cohort prospective observational study was undertaken to include women with early pregnancy loss, ≤ 12 weeks of gestation, managed with mifepristone (200 mg) and misoprostol (1600 μg) followed by PI and RI evaluation of both uterine arteries 2 weeks after...
February 13, 2015: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/25701235/overview-and-expert-assessment-of-off-label-use-of-misoprostol-in-obstetrics-and-gynaecology-review-and-report-by-the-coll%C3%A3-ge-national-des-gyn%C3%A3-cologues-obst%C3%A3-triciens-fran%C3%A3-ais
#8
REVIEW
H Marret, E Simon, G Beucher, M Dreyfus, A Gaudineau, C Vayssière, M Lesavre, M Pluchon, N Winer, H Fernandez, J Aubert, T Bejan-Angoulvant, A P Jonville-Bera, E Clouqueur, V Houfflin-Debarge, A Garrigue, F Pierre
The literature suggests that misoprostol can be offered to patients for off-label use as it has reasonable efficacy, risk/benefit ratio, tolerance and patient satisfaction, according to the criteria for evidence-based medicine. Both the vaginal and sublingual routes are more effective than the oral route for first-trimester cervical dilatation. Vaginal misoprostol 800μg, repeated if necessary after 24 or 48h, is a possible alternative for management after early pregnancy failure. However, misoprostol has not been demonstrated to be useful for the evacuation of an incomplete miscarriage, except for cervical dilatation before vacuum aspiration...
April 2015: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/25626593/previous-miscarriage-and-the-subsequent-risk-of-preterm-birth-in-scotland-1980-2008-a-historical-cohort-study
#9
C Oliver-Williams, M Fleming, A M Wood, Gcs Smith
OBJECTIVE: To determine whether the relationship between previous miscarriage and risk of preterm birth changed over the period 1980-2008, and to determine whether the pattern varied according to the cause of the preterm birth. DESIGN: Linked birth databases. SETTING: All Scottish NHS hospitals. POPULATION: A total of 732 719 nulliparous women with a first live birth between 1980 and 2008. METHODS: Risk was estimated using logistic regression...
October 2015: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/25447362/-obtaining-of-uterine-vacuity-in-pregnancy-loss
#10
G Beucher, P Dolley, Z Stewart, V Lavoué, X Deffieux, M Dreyfus
OBJECTIVE: To assess early and late benefits and harms of different management options for first trimester miscarriage and for induction of labor and obtaining of uterine vacuity in case of fetal death beyond of 14weeks of gestation. METHODS: French and English publications were searched using PubMed and Cochrane Library. RESULTS: Concerning missed miscarriage, expectant management is not recommended (LE1) because it increases the risk of failure, need of unplanned surgical procedure and blood transfusion (LE1)...
December 2014: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/25404439/manual-vacuum-aspirator-a-safe-and-effective-tool-for-decentralization-of-post-miscarriage-care
#11
Nasira Tasnim, Saba Fatima, Ghazala Mahmud
OBJECTIVE: To compare the efficacy and safety of Manual Vacuum Aspiration (MVA) performed as outpatient versus inpatient procedure in terms of success rate, blood loss, hospital stay and procedure related complications. STUDY DESIGN: A quasi-experimental study. PLACE AND DURATION OF STUDY: Maternal and Child Health Centre (MCHC), Unit-I, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from December 2009 to December 2010. METHODOLOGY: Cases with early pregnancy failure (incomplete, missed and an embryonic) at gestational age less than 12 weeks were allocated to MVA as outpatient or elective procedure performed in the operation theatre...
November 2014: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/25153436/-first-trimester-miscarriages-benefits-and-harms-of-different-management-options
#12
REVIEW
G Beucher, P Dolley, Z Stewart, G Carles, M Dreyfus
The objective of this review was to assess early and late benefits and harms of different management options for first-trimester miscarriage. Surgical uterine evacuation remains the most effective and the quickest method of treatment. Depending on the clinical situation, medical treatment using misoprostol (missed miscarriage) or expectative attitude (incomplete miscarriage) does not increase the risk of complications, neither haemorrhagic nor infectious. However, these alternatives generally require longer outpatient follow-up, which leads to more prolonged bleeding and not planned surgical procedures...
September 2014: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/24868466/expectant-management-of-miscarriage-in-view-of-nice-guideline-154
#13
Junaid Rafi, Haroona Khalil
Objective. To find out the success rate of conservative management of complete two weeks for miscarriage in view of NICE Guideline 154. Design. Prospective observational study. Setting. Early pregnancy assessment units of District General Hospital in the United Kingdom. Participants. Women of less than 14 weeks' gestation, with a diagnosis of miscarriage (missed miscarriage/anembryonic or incomplete miscarriage). Interventions. Expectant management for two weeks. Main Outcome Measure. (1) Efficacy of 2-week expectant management, that is, complete resolution of miscarriage based either on self-reporting of patient after passing products of conception at home between D0 and D14 of expectant management or confirmation on scan at D14, and (2) short-term complications needing strong analgesia, blood transfusion, and antibiotics...
2014: Journal of Pregnancy
https://www.readbyqxmd.com/read/24813099/a-randomised-controlled-trial-of-expectant-management-versus-surgical-evacuation-of-early-pregnancy-loss
#14
RANDOMIZED CONTROLLED TRIAL
Ravichandran Nadarajah, Yek Song Quek, Kaliammah Kuppannan, Shu Yuan Woon, Ravichandran Jeganathan
OBJECTIVE: To show whether a clinically significant difference in success rates exists between expectant and surgical management of early pregnancy loss. STUDY DESIGN: Randomised controlled trial comparing expectant versus surgical management of early pregnancy loss over a 1-year period from 1st January to 31st December 2009 at Sultanah Aminah Hospital, Johor Bahru. Pregnant women with missed or incomplete miscarriages at gestations up to 14 weeks were recruited in this study...
July 2014: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/24768979/conservative-management-of-placenta-accreta-hysteroscopic-resection-of-retained-tissues
#15
Guillaume Legendre, Félicia Joinau Zoulovits, Juliette Kinn, Loïc Senthiles, Hervé Fernandez
STUDY OBJECTIVE: To evaluate the feasibility and the results of hysteroscopic removal of tissue after conservative management of retained placenta accreta. DESIGN: Retrospective study (Canadian Task Force classification II-3). SETTING: Tertiary care university hospital. PATIENTS: Twelve consecutive patients with hysteroscopic resection of retained tissues after conservative management of placenta accreta. INTERVENTION: Hysteroscopic removal of retained placenta tissue using a 24F bipolar resectoscope...
September 2014: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/24483325/management-of-a-second-trimester-miscarriage-in-a-woman-with-an-incarcerated-retroverted-uterus
#16
H Matsushita, K Watanabe, A Wakatsuki
No abstract text is available yet for this article.
April 2014: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/24401287/proceedings-from-the-third-national-institutes-of-health-international-congress-on-advances-in-uterine-leiomyoma-research-comprehensive-review-conference-summary-and-future-recommendations
#17
James H Segars, Estella C Parrott, Joan D Nagel, Xiaoxiao Catherine Guo, Xiaohua Gao, Linda S Birnbaum, Vivian W Pinn, Darlene Dixon
BACKGROUND Uterine fibroids are the most common gynecologic tumors in women of reproductive age yet the etiology and pathogenesis of these lesions remain poorly understood. Age, African ancestry, nulliparity and obesity have been identified as predisposing factors for uterine fibroids. Symptomatic tumors can cause excessive uterine bleeding, bladder dysfunction and pelvic pain, as well as associated reproductive disorders such as infertility, miscarriage and other adverse pregnancy outcomes. Currently, there are limited noninvasive therapies for fibroids and no early intervention or prevention strategies are readily available...
May 2014: Human Reproduction Update
https://www.readbyqxmd.com/read/24370213/an-epidemiological-survey-on-low-birth-weight-infants-in-china-and-analysis-of-outcomes-of-full-term-low-birth-weight-infants
#18
Yi Chen, Guanghui Li, Yan Ruan, Liying Zou, Xin Wang, Weiyuan Zhang
BACKGROUND: Low birth weight (LBW) is one of the leading causes of adverse perinatal outcomes and is closely related to neonatal disease and death. The incidence of LBW has been increasing. The aim of this study was to investigate the current incidence rate and factors affecting low birth weight infants and perinatal outcomes of full-term low birth weight infants in mainland China. METHODS: This paper describes a retrospective analysis of children born in 39 hospitals of different types in 14 different provinces, municipalities, and autonomous regions in seven districts within China throughout 2011...
2013: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/24240972/expectant-versus-surgical-management-of-first-trimester-miscarriage-a-randomised-controlled-study
#19
RANDOMIZED CONTROLLED TRIAL
Wael Al-Ma'ani, Erich-Franz Solomayer, Mohamad Hammadeh
INTRODUCTION: The aim of this study is to compare the efficacy and safety of expectant management with surgical management of first-trimester miscarriage. METHODS: This randomised prospective study was conducted in the Gynaecology Department at University of Saarland Hospital, Germany between February 2011 and April 2012. A total of 234 women were recruited following diagnosis of the first-trimester incomplete or missed miscarriage and randomised into two groups: 109 women were randomised to expectant management (group I), and 125 women to surgical management (groupII)...
May 2014: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/24151775/congenital-discrete-subaortic-stenosis-in-pregnancy-case-report-and-literature-review
#20
REVIEW
Maya Guglin, Olga Kristof-Kuteyeva
Today's growing numbers of pregnant patients with congenital heart defects presents challenges for cardiologists treating adult patients. The case is presented of a 19-year-old woman who was admitted with a threatened miscarriage in the third trimester and was diagnosed with an incomplete atrioventricular canal, cleft mitral valve with severe regurgitation, and severe congenital subaortic stenosis caused by a subaortic membrane. She was managed conservatively, delivered via cesarean section, and then underwent surgical repair of all defects with good outcome...
May 2013: Journal of Heart Valve Disease
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