Miscarriage is common in early pregnancy. Such loss can affect physical and mental health. Doctors often suggest surgery such as dilation and curettage (D & C) to complete the process. The goal is to spare the woman bleeding or infection. Expectant management means waiting for the miscarriage to finish on its own. This review looked at whether expectant management worked as well as surgery for miscarriage.
We searched for randomized trials that compared waiting with surgery for miscarriage. In addition, we looked at reference lists to find trials. We also wrote to researchers to find more studies. Five trials with 689 women looked at waiting versus surgery for miscarriage.
More women who waited for the miscarriage to complete on its own had tissue left in the womb, and they needed surgery to complete the process. These women also had more bleeding. Women who had surgery to empty the womb more often got an infection. No strong medical results argue for either approach. Information was very limited on mental health or future pregnancy.
Both waiting for the miscarriage to finish and having surgery are appropriate choices. What the woman prefers should be the major concern.