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Title: Conservative management of spontaneous miscarriage
Author: Shehata, Kamal I.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2006
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The work in this thesis is mainly focused on the role of conservative management of women with retained products of conception following a spontaneous miscarriage in the first trimester in comparison to the ‘gold standard’ surgical evacuation of the uterine cavity under general anaesthesia. A self-administered questionnaire based study was conducted to investigate the impact of seeing and handling the products of conception on the incidence of psychological adverse reactions in women managed conservatively as compared to the control group (women managed by surgical uterine evacuation). Women managed conservatively seemed to recover psychologically quicker than women managed by surgical evacuation. The impact of conservative management on the reproductive potential of women with retained products of conception was assessed in the fourth chapter. The first part of the fourth chapter studied the return of ovulation in a subgroup of women (n = 30) randomised to conservative management as compared to women (n = 30) randomised to surgical evacuation. The return of normal ovulation was examined by assessing the daily urinary excretion of luteinizing hormone (LH), pregnanediol (P4) and total urinary oestrogen (E2), follicular and endometrial development using transvaginal ultrasound. The second part of this chapter concentrated on following up women who desired to become pregnant from the two management groups. Conservative management had similar outcomes to surgical evacuation in relation to the reproductive performance. Finally, a systematic assessment of the cost-effective of conservative management was carried out in comparison with surgical evacuation in the last chapter of the thesis, which revealed a potential for substantial cost savings in NHS resources with the widespread use of conservative management.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available