title: Does symptomatology at presentation correlate with successful expectant management of first trimester miscarriage: a prospective observational study.
abstract: OBJECTIVE
  To evaluate whether symptomatology at presentation correlates with successful expectant management of first-trimester miscarriage.
  
  
  METHODS
  Data were collected prospectively on women managed expectantly for two weeks with first-trimester miscarriage. Women diagnosed with incomplete, missed and empty sac miscarriage were included. The overall rate of successful expectant management was evaluated in terms of symptomatology. The rates of successful expectant management for each miscarriage group were also evaluated in terms of the type of symptoms. Main outcome measure was success of expectant management at two weeks.
  
  
  RESULTS
  Spontaneous completion of miscarriage was observed in 76.7% (161/210) women. The overall rates of successful expectant management were significantly different between the symptomatic (79.1%) and asymptomatic (42.9%) groups (P-value = 0.0003). In the incomplete miscarriage group, higher rates of success were associated with vaginal bleeding than without (89.4 vs 56.3%; P-value = 0.0027). The presence or absence of pain was not found to be significant.
  
  
  CONCLUSIONS
  Symptomatology does appear to be a consistent predictor of outcome for expectant management of miscarriage. Overall, vaginal bleeding at presentation was associated with an increase in success of expectant management; but individually, only significant in the incomplete miscarriage group. The presence or absence of pain at presentation was not a predictor for the various types of miscarriage.
authors.affiliation: Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Nepean Centre for Perinatal Care, Nepean Clinical School, University of Sydney, Nepean Hospital, Sydney, New South Wales, Australia. i_vidyasagar@hotmail.com
authors.forename: Ishwari
authors.initials: I
authors.lastname: Casikar
authors.forename: Chuan
authors.initials: C
authors.lastname: Lu
authors.forename: Shannon
authors.initials: S
authors.lastname: Reid
authors.forename: George
authors.initials: G
authors.lastname: Condous
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000027:Abortion, Incomplete / Q000628:therapy*; D000030:Abortion, Missed / Q000628:therapy*; D058070:Asymptomatic Diseases / Q000628:therapy*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000209:etiology*; D057832:Watchful Waiting