Clinical inquiries. How long is expectant management safe in first-trimester miscarriage?

Charles Butler, Gary Kelsberg, Leilani St Anna, Paul Crawford

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


More than 80% of women with a first-trimester spontaneous abortion have complete natural passage of tissue within 2 to 6 weeks with no higher complication rate than that from surgical intervention (strength of recommendation [SOR]: A, based on multiple randomized controlled trials [RCTs] and cohort studies). Expectant management is successful within 2 to 6 weeks without increased complications in 80% to 90% of women with first-trimester incomplete spontaneous abortion and 65% to 75% of women with first-trimester missed abortion or anembryonic gestation (presenting with spotting or bleeding and ultrasound evidence of fetal demise) (SOR: B, based on multiple cohort studies). There is no difference in short-term psychological outcomes between expectant and surgical management (SOR: B, based on RCT). Women experiencing spontaneous abortion with unstable vital signs, uncontrolled bleeding, or evidence of infection should be considered for surgical evacuation (SOR: C, expert opinion).

Original languageEnglish
Pages (from-to)889-90
Number of pages2
JournalJournal of Family Practice
Issue number10
StatePublished - Oct 2005


  • Abortion, Spontaneous/diagnosis
  • Clinical Trials as Topic
  • Evidence-Based Medicine
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Trimester, First


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