[The practice guideline 'Miscarriage' (second revision) from the Dutch College of General Practitioners; a response from the perspective of gynaecology].
In March 2004, the Dutch College of General Practitioners issued its revised guideline on the management of miscarriage. The older version of the guideline advised expectant management of all patients with first-trimester vaginal bleeding without ultrasonographic evaluation. In contrast, the new version has accepted the importance of ultrasonographic assessment, which offers insight into the patient's prognosis. This enables GPs to discuss the further management options with women in whom a non-vital pregnancy has been diagnosed: expectant management or referral to a unit for removal of the products of conception by means of vacuum curettage. Since the patient's management preferences have now also been acknowledged, the new guideline is better for all parties involved in this common clinical problem.
Ankum
W M
WM
Academisch Medisch Centrum, afd. Verloskunde en Gynaecologie, Meibergdreefg, 1105 AZ Amsterdam. w.m.ankum@amc.uva.nl
D000022:Abortion, Spontaneous / Q000517:prevention & control* / Q000523:psychology / Q000628:therapy; D000328:Adult; D005260:Female; D006176:Gynecology; D006801:Humans; D009426:Netherlands; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D014592:Uterine Hemorrhage / Q000209:etiology