One-Year Management Experience in an Early Pregnancy Unit in Portugal

Background In the last years standard management of spontaneous abortion (SA) and voluntary interruption of pregnancy (VIP) has changed with the development of several approaches which allow, in some cases, treatment on an outpatient basis.

Objective The objective of this study was to evaluate the results of management of SA and VIP in our Early Pregnancy Unit.

Methods We analysed SA (before the 10th week of gestation) and VIP supervised in our institution during 2015. Our early pregnancy loss protocol includes 3 steps: first consultation where is provided information, one day in the Unit to vaginal misoprostol administration, medical revaluation and referral for further treatment, if necessary, and a review appointment. Our VIP protocol include a first medical consultation, 3-day reflection period, medical protocol, usually on an outpatient basis, and a review appointment.

Results 284 SA and 1009 VIP were supervised in our Unit during 2015. In the first group mean maternal age was 33 years, 35,9% were primigravidae and 32,7% had previous SA. The mean gestational age at diagnosis was 7 weeks. Expulsion occurred spontaneously after first consultation in 31% of cases, during misoprostol administration in our Unit in 43% and during expectant management after protocol in 14% of cases. Expulsion not occurred in 12% of cases, 30 women needed surgery to complete the process.

In the VIP group mean maternal age was 28 years, 41,7% were primigravidae and 21,2% had at least one previous VIP. The mean gestational age was 7 weeks. Protocol had failure in 3,4% of cases, 7 of them proceeded pregnancy and 26 women needed surgery to complete the process.

Conclusion We think we have good results in the management of these women and we will continuing working to minimise failures, improve protocols and provide all social, psychological and medical support that these women need.