Managements Of Missed Abortion

Background Missed abortion is defined as a nonviable pregnancy that has been retained in the uterus without spontaneous passage for several weeks since the demise. It is a kind of early pregnancy failure. When the nonviable pregnancy retained in the uterus for a long time, it may lead to coagulation functional disturbance and hemorrhage, even more, the disseminated intravascular coagulation. In recent years, the incidence of missed abortion has increased to 3% in our hospital. There are many different managements of missed abortion. In this study, we evaluate the case in recent seven years. To determine the management of missed abortion.Objective To determine the management of missed abortion.Method Six hundreds and thirty nine cases were enrolled in this study, including 519 with medical management,125 with surgical evacuation and 49 with expectant management.Results The success rate of medical management was 93.83%, compared with 98.40% for surgical evacuation, and with 67.35% for expectant management (p<.005). Of the 519 women,18 had heavy vaginal bleeding, none of 94 women had heavy vaginal bleeding and of 49 women,3 had heavy vaginal bleeding (p>.005).Of the 519 women,397 women had vaginal bleeding before treatment and 122 women had not, 93 women had used progesterone and 426 had not,234 women had used osmotic dilators and 285 women had not and there was no significant difference in the successful rate of them (p>.005).Of 234 women used osmotic dilators,7 women had severe abdominal pain, and of 285 women used osmotic dilators,25 had severe abdominal pain (p<.005). Of the 519 women,101 women with medical management droped out the conception experienced immediately vacuum aspiration,all of them were completely abortion when the 2 weeks follow-up. And 386 women had no immediately vacuum aspiration,7 of them were incompletely abortion (p>.005).Conclusion The success rate of medical management is 93.83%, compared with 98.40% for surgical evacuation, and with 67.35% for expectant management. The women with medical management need not vacuum aspiration immediately after the removel of conception. Vaginal bleeding, used progesterone and used osmotic dilators do not increase the success rate of medical management and used osmotic dilators may reduce abdominal pain. Expectant management should not be used in clinical practice.