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Treatment of miscarriage: current practice and rationale
1National Research and Development Centre for Welfare and Health, Health Services Research Unit, Helsinki, Finland. elina.hemminki@stakes.fi
Obstetrics and Gynecology
|February 20, 1998
Summary
Most women experiencing miscarriage in Finland received physician care and inpatient treatment, often involving uterine evacuation. However, these common miscarriage treatment practices lack support from controlled scientific studies.
Area of Science:
- Reproductive Health
- Gynecology
- Healthcare Services Research
Background:
- Miscarriage management is a significant aspect of women's reproductive healthcare.
- Understanding current treatment practices and their evidence base is crucial for improving care.
Purpose of the Study:
- To document health service utilization for miscarriage in Finland.
- To investigate the rationales and evidence supporting medical miscarriage treatments.
Main Methods:
- Utilized a national survey of women aged 18-44 (n=326 reporting miscarriage).
- Analyzed national hospital discharge register data (1988, 1995).
- Reviewed medical textbooks (1950-1994) and searched for controlled studies on miscarriage interventions.
Main Results:
- 97% of women with miscarriage saw a physician; 74% were inpatients.
- Operative uterine evacuation was the predominant treatment (84-88% in 1988/1995).
- No controlled studies were found to empirically support these routine practices.
Conclusions:
- Current miscarriage treatment protocols in Finland are not evidence-based.
- There is an urgent need for clinical trials to evaluate all aspects of miscarriage care, including provider choice and interventions.