The role of ultrasound in the expectant management of early pregnancy loss.
OBJECTIVE
To define the sonographic criteria which best determine the likelihood of successful expectant management of early pregnancy failure (EPF).


METHODS
Women with an ultrasound diagnosis of EPF at 7-14 weeks' gestation were offered the option of expectant management or surgical evacuation.


RESULTS
Five hundred and forty-five women had a diagnosis of EPF; 298 with incomplete miscarriage and 247 with missed miscarriage or an embryonic pregnancy. A total of 305 women opted for expectant management, with an overall success rate of 86%. The success rate for incomplete miscarriage (96%) was significantly better than that for missed miscarriage (62%).


CONCLUSIONS
This study demonstrates that EPF can be safely managed expectantly. Ultrasound has an invaluable role in predicting the likelihood of successful expectant management enabling patients to make an informed choice about their medical care.
Sairam
S
S
Early Pregnancy Assessment Unit, Homerton Hospital, Academic Department of Obstetrics and Gynaecology, St Bartholomew's and The Royal London Hospitals School of Medicine and Dentistry, London, UK.
Khare
M
M
Michailidis
G
G
Thilaganathan
B
B
D000027:Abortion, Incomplete / Q000000981:diagnostic imaging* / Q000628:therapy*; D000030:Abortion, Missed / Q000000981:diagnostic imaging* / Q000628:therapy*; D000328:Adult; D016001:Confidence Intervals; D004107:Dilatation and Curettage / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D016017:Odds Ratio; D010358:Patient Participation; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal / Q000379:methods*