Human Aziz, Shagufta Saeed, Mariam Malik, Fouzia Nazir, Saadat Aliya, Saad Rana.
Early Pregnancy Failure - Non-surgical Management.
Pak J Obstet Gynaecol Jan ;12(1,2):33-9.

Early pregnancy failure is the commonest complication of pregnancy. The aim of the present study is to highlight the results of conservative approach after early pregnancy failure to minimize surgical intervention. This retrospective study was carried out over a period of 2 years (1996-1998) on 50 cases of early pregnancy loss from Women Clinic and Fertility Advisory Center (WCFAC) Islamabad, designated Group A and 31 cases from Holy Family Hospital (HFH) Rawalpindi, included in Group B. Detailed History taking was followed by ultrasound confirmation of incomplete abortion or missed pregnancy. Gestational age was between 4-13 weeks, with 13 (9%) cases between 4-6 weeks, 27 (33.3%) between 7-10 weeks while maximum number of cases 41 (50.6%) ranging between 10-13 weeks. On ultrasonography only gestational sac was seen in 34 (41.4%) cases, retained products of conception in 28 (34.5%) cases, gestational sac with yolk sac and embryonic shadows in 10 (12.3%), yolk sac within the gestational sac 4 (4.9) cases while only decidual reaction was seen in 5 (6.1%). All the 13 cases belonging to both the groups between 4-6 weeks and 17 (62.5%) women with 7-10 weeks amenorrhea were settled without any medication. Medication with tablet methergen to control bleeding was given to 10 (37%) females between 7-10 weeks. Out of 41 cases between gestational age 11-13 weeks 19 (49.3%) cases were settled without medication while an equal 19 cases required tablet methergen with only (37.3%) cases requiring surgical intervention. Therefore 78 (96%) cases in our study were managed by conservative approach signifying the importance of this mode of management with potential benefits to women in terms of cost saving and decrease in the rate of complication due to surgical intervention.

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