RT Journal Article
SR Electronic
T1 Spontaneous Abortion In Primary Care
JF The Journal of the American Board of Family
                Practice
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 15
OP 23
DO 10.3122/jabfm.1.1.15
VO 1
IS 1
A1 A Report From ASPN
YR 1988
UL http://www.jabfm.org/content/1/1/15.abstract
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.