Status, pregnancy history influence treatment decisions for miscarriage

Study shows socioeconomic status and prior pregnancy steer women's treatment choices after miscarriage.
By Amy Wallace  |  Jan. 10, 2017 at 2:32 PM
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PHILADELPHIA, Jan. 10 (UPI) -- A new study from the University of Pennsylvania found that socioeconomic status and prior pregnancy influence women's treatment choices during miscarriage.

Women who experience miscarriages are commonly offered three treatment options by doctors: a surgical procedure to complete the miscarriage, a drug to induce expulsion, or to wait for natural completion to occur.

Researchers at the Perelman School of Medicine at the University of Pennsylvania sought to determine the influences that affect which treatment option women choose.

"We found that women who are experiencing the loss during their first-ever pregnancy are most vulnerable to feeling overwhelmed by the treatment decision and seek expert advice from their providers," Dr. Courtney A. Schrelber, associate professor of Obstetrics and Gynecology at Penn., and lead author of the study, said in a press release. "Couples are usually not referred to specialists until they have had two or more miscarriages, but our findings provide important insights that suggest that expert care for patients is necessary every time."

For the study, researchers conducted in-depth interviews with 55 women who had experienced a miscarriage, along with 15 obstetrician-gynecologists.

The results showed 34 women of the 55 chose to complete the process of miscarriage with surgery and 19, or one-third, of the women used medication to complete the process.

The patients who chose surgery were more likely to have a higher monthly income and more social support than the women who chose medication. The women who chose medication indicated an aversion to surgery and concern that surgery would reduce fertility.

"Patient satisfaction was driven more by clinical efficiency and a feeling that the care team was compassionate, regardless of the management choice," Schreiber said, adding that the findings support the need for evidence-based, patient-centered care for women who have miscarriages.

The study was published in Obstetrics and Gynecology.

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