Patient preferences for expectant management vs. surgical evacuation in first-trimester uncomplicated miscarriage.
OBJECTIVE
Expectant and surgical management are widely accepted treatment options in case of a miscarriage. In the absence of differences in complications, the choice between both options can be based on patient preferences.


METHODS
We studied treatment preferences for future miscarriages in women with a miscarriage randomized to expectant or surgical treatment or managed according to their own choice.


RESULTS
Data from 136 patients were analyzed. Women randomized either to expectant or surgical management opted for the allocated treatment in future in 55 and 74%, respectively. Of the women randomized to expectant management and with a successful spontaneous loss, 71% opted again for this treatment. Women who were managed according to their own treatment choice, held on to their initial treatment preference (expectant vs. surgical management; 84 and 88%, respectively). Preferences after treatment were strong.


CONCLUSIONS
A strong treatment preference should be taken into account in the counseling process. Women without a preference should be well informed on all medical aspects of the two options in order to facilitate informed-shared decision-making.
Wieringa-de Waard
Margreet
M
Department of General Practice/Family Medicine, Academic Medical Center-University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands. m.wieringa@amc.uva.nl
Bindels
Patrick J E
PJ
Vos
Jeroen
J
Bonsel
Gouke J
GJ
Stalmeier
Peep F M
PF
Ankum
Willem M
WM
D000022:Abortion, Spontaneous / Q000601:surgery / Q000628:therapy*; D000328:Adult; D005260:Female; D006801:Humans; D017060:Patient Satisfaction; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D016032:Randomized Controlled Trials as Topic; D015983:Selection Bias; D016896:Treatment Outcome; D014619:Vacuum Curettage