Management of spontaneous abortion in family practices and hospitals.

BACKGROUND AND

OBJECTIVES

We performed two retrospective chart surveys, the first of 200 consecutive hospital emergency visits for spontaneous abortion and the second in 33 family physicians' offices examining 245 patients with spontaneous abortions. This study determined the rate of surgical management of spontaneous abortions within family practices and hospitals, as well as the rate of referrals and complications.

METHODS

In the retrospective chart surveys, the information collected included the number of spontaneous abortions, dilation and curettages (D&Cs), referrals, and complications.

RESULTS

Of the women presenting to the hospitals, 92.5% had D&Cs, while 51% of the women presenting to family physicians had D&Cs. Of the women presenting to the hospitals, 99.5% were referred to gynecologists, compared with 41% of the family practice patients. Hemorrhage occurred in 4.6% of the hospital patients and 2% of the family practice patients. Infection occurred in 6% of the hospital patients and .8% of the family practice patients.

CONCLUSIONS

Patients with spontaneous abortions who saw their family physicians were more likely to be managed conservatively than those seen in the hospitals. There was no increase in complications in the conservatively managed patients.