Setting for surgical management of miscarriage

DetailsAdditional comments
Review questionWhat is the effectiveness of surgical management of miscarriage in an outpatient (office) setting compared with any other setting for improving women's clinical and psychological outcomes?
ObjectivesTo compare manual vacuum aspiration under local anaesthetic with traditional surgical procedure under general anaestheticLocal here means anything that allows surgical procedure to be done as an out-patient
LanguageEnglish
Study designIdeal:

Systematic reviews of randomised controlled trials (RCTs)

RCTs

Cohort studies

Case series if no comparative studies found (>10)

Qualitative studies
StatusPublished papers
PopulationPopulation includes:

Women diagnosed with an ongoing miscarriage

Women diagnosed with a missed miscarriage

Population excludes:

Women diagnosed with threatened miscarriage
  • Search terms
Inevitable miscarriage

Incomplete miscarriage
InterventionSurgical management (vacuum aspiration with or without dilatation (no curettage) with any anaesthesia which allows an ‘office’ procedureThis is a proxy for outpatient

Search terms: Office gynaecology

Clinic

Out-patient clinic

Polyclinic
ComparatorSurgical management with any anaesthesia which entails an in-patient procedure: dilatation, evacuation of retained products, dilation and curettageThis is a proxy for inpatient

In-patient

General anaesthetic

Theatre (operating)
OutcomesMeasures of pain

Need for further interventions (any further intervention)

Readmission/admission tohospital

Adverse effects of treatment/surgical complications

Women's views/experiences of care and initial follow-up
Other criteria for inclusion/exclusion of studiesExclude additional treatment and management required by women with recurrent miscarriage

Exclude emergency management of women with acute presentations of shock and collapse

Exclude developing countries

Exclude women presenting with diagnosed molar pregnancy

From 1990 onwards

From: Appendix D, Review protocols

Cover of Ectopic Pregnancy and Miscarriage
Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management in Early Pregnancy of Ectopic Pregnancy and Miscarriage.
NICE Clinical Guidelines, No. 154.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG; 2012 Dec.
Copyright © 2012, National Collaborating Centre for Women's and Children's Health.

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