PT  - JOURNAL ARTICLE
AU  - A Report From ASPN
TI  - Spontaneous Abortion In Primary Care
AID  - 10.3122/jabfm.1.1.15
DP  - 1988 Jan 01
TA  - The Journal of the American Board of Family
                Practice
PG  - 15--23
VI  - 1
IP  - 1
4099  - http://www.jabfm.org/content/1/1/15.short
4100  - http://www.jabfm.org/content/1/1/15.full
SO  - J Am Board Fam Med1988 Jan 01; 1
AB  - The Ambulatory Sentinel Practice Network (ASPN) conducted an observational study of usual primary care of spontaneous abortion (SAB). Forty-nine practices in 18 states and four Canadian provinces reported and audited 171 SABs. Contrary to recommendations in some texts, 40 percent were managed completely in the office and/or at home, and only 51 percent had a dilatation and curettage (D&C). SABs occurring later in pregnancy were more likely to be managed in the emergency room/hospital, receive consultation, and have a D&C. Patients managed with D&C had a greater frequency of excessive blood loss at diagnosis, but otherwise they did not differ in terms of complications at diagnosis or follow-up from those who did not. Adverse psychological consequences were subjectively observed by ASPN clinicians in 24 percent of women, exceeding any other category of complications. Management of all SABs in a hospital with D&C, instead of the management observed in this study, could add $145,000,000 per year to health care expenditures in the United States.