Somaia Elsayed
The Coombe Women and Infants University Hospital, IrelandTitle: Women’s Experience of First Trimester Miscarriage: Comparison of Expectant, Medical and Surgical Management.
Abstract
Miscarriage is a frequent complication in early pregnancy. Assessing patient’s experience, satisfaction and psychological burden of the different forms of managements is therefore important.
The aim of the study was to compare women's experience of the three management options including expectant, medical and surgical management. Satisfaction level, time taken off work and psychological impact were assessed.
Women were recruited prospectively from the early pregnancy unit following a diagnosis of first-trimester miscarriage [October-2015 and April 2017]. An online survey including the Edinburgh Postnatal Depression score (EPDS) was emailed to the women 6-8 weeks following recruitment. SPSS was used to analyse the data.
In total, 235 women completed the survey. Almost half had surgical management, 48.1% (113); 42.6% (100) had medical and 9.4% (22) had expectant management. There was a significant difference in the satisfaction level between the 3 options with the medical management having the lowest satisfaction level (surgical 89%, expectant 82%, medical 53% satisfied; P=<0.01). The satisfaction level was significantly linked to the success of management (p= (0.01). Women undergoing medical management were more likely to take more time off work (P= 0.01), and more likely to score higher on the EPDS (p=0.05).
women experience with miscarriage varies depending on the type of management. In this study, women undergoing expectant and surgical management seem to have higher satisfaction levels, take less time off work and have lower scores on the EPDS. More research is needed to assess to factors contributing to the negative experience with medical management.
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