Management of first trimester spontaneous abortions

doi:10.1136/bmj.310.6992.1426

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Kevin Forbes

Senior lecturer Department of Obstetrics and Gynaecology, University of Queensland, Royal Brisbane Hospital, Herston 4029, Australia

May be expectant treatment for up to three days in selected cases

Many procedures in obstetrics and gynaecology are ripe for re-evaluation. On the basis of a recent paper,1 surgical evacuation of the uterine contents after all miscarriages in the first trimester may be one of them.

The rationale for curettage as the correct management is based on a series of cases published when parity, general health, and the incidence of criminal abortion differed greatly from now.2 Doctors reported infection (due to retained products of conception after criminal abortion) and bleeding against a background of anaemia, multiparity, and poor nutrition. …