Protocol for management of unsuccessful pregnancy
Hodgson, J.E.; Ditmanson, G.M.
Minnesota Medicine 63(2): 134-138
1980
ISSN/ISBN: 0026-556X PMID: 7382975 Document Number: 156058
Complications of unsuccessful pregnancy (including intrauterine fetal death, missed abortion, gross fetal abnormalities, and hydatidiform mole) and their successful management are reviewed as 21 such cases are reported retrospectively. In all cases of pregnancy complication, active management is recommended; such management is many times determined by the gestational week in which the pregnancy failed. Dilatation and evacuation are used for gestations from 12-18 weeks; and prostaglandin induction is indicated for pregnancies of greater than 18 weeks in size. In these 21 cases, 6 underwent dilatation and evacuation (using laminaria tents as well), 8 underwent laminaria insertion followed by extraamniotic prostaglandin F2 alpha and oxytocin augmentation, 4 patients were treated with prostaglandin E2 vaginal suppositories augmented by laminaria. Based on these results a preference is indicated for continuous extraamniotic infusion of PGF2 alpha vs. prostaglandin E2 suppositories. Also advocated is treatment as outpatient whenever possible.