After a miscarriage – can we tell who might need an operation

A miscarriage is traumatic irrespective of the treatment received in hospital. In gernal the trend is towards expectant management for miscarriage – in other words a watcvh and wait approach. However there problem is that some some women will find that they need surgery to resolve their miscarriage. After being left in limbo hope to avoid intervention this can add further distress to a difficult situation..

A┬árecent paper from George Condous and colleagues from the University of Sydney suggests that assessing blood flow in the uterus after miscarriage may help pick out women who will need surgery – and so avoid waiting to see if intervention is needed.

In then study 158 women with a miscarriage were followed up expectantly. Thise with no flow in the uterine cavity using power Doppler were significantly more likely to resolve the miscarriage without intervention compared to those with flow (89 versus 61%). Not huge differences but they may help clinicians advise individual patients how likely they are to end up needing surgery – and may tilt the balence in favour of earlier intervention ins some women.

The paper can be reviewed at the following site: http://www.ncbi.nlm.nih.gov/pubmed/22232130

 

Professor Tom Bourne

Professor Tom Bourne is Adjunct Professor at Imperial College London, and Consultant Gynaecologist at Queen Charlotte's and Chelsea Hospital. He is also visiting Professor at KU Leuven, Belgium. He has extensive clinical and research experience in early pregnancy care as well as gynaecological ultrasound. He has published over 300 academic papers with an H-index of 63. He advises NICE, is trustee of the ectopic pregnancy trust, President of the UK association of early pregnancy units (AEPU) and on the board of ISUOG. He has a private practice at The Women's Ultrasound Centres at 86 Harley Street and Parkside Hospital in Wimbledon.

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About Professor Tom Bourne

Professor Tom Bourne is Adjunct Professor at Imperial College London, and Consultant Gynaecologist at Queen Charlotte's and Chelsea Hospital. He is also visiting Professor at KU Leuven, Belgium. He has extensive clinical and research experience in early pregnancy care as well as gynaecological ultrasound. He has published over 300 academic papers with an H-index of 63. He advises NICE, is trustee of the ectopic pregnancy trust, President of the UK association of early pregnancy units (AEPU) and on the board of ISUOG. He has a private practice at The Women's Ultrasound Centres at 86 Harley Street and Parkside Hospital in Wimbledon.
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