Clinical inquiries. How long is expectant management safe in first-trimester miscarriage?
Clinical inquiries. How long is expectant management safe in first-trimester miscarriage?
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临床询问。
DOI：
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
P. Crawford
中科院分区：
文献类型：
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作者：
C. Butler;G. Kelsberg;Leilani St Anna;P. Crawford
超过80%的孕早期自然流产女性在2至6周内自然完全排出组织，其并发症发生率并不高于手术干预（推荐强度[SOR]：A，基于多项随机对照试验[RCT]和队列研究）。在孕早期不完全自然流产的女性中，期待治疗在2至6周内成功率为80% - 90%，在孕早期稽留流产或无胚胎妊娠（表现为点滴出血或出血且超声显示胎儿死亡）的女性中成功率为65% - 75%，且无并发症增加（SOR：B，基于多项队列研究）。期待治疗和手术治疗在短期心理结果方面没有差异（SOR：B，基于随机对照试验）。出现自然流产且生命体征不稳定、出血未控制或有感染迹象的女性应考虑手术清宫（SOR：C，专家意见）
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).