A Comparison of the Number of Patient Visits Required for Different Management Options for Early Pregnancy Loss at an Early Pregnancy Assessment Clinic

Abstract

ObjectiveTo compare the total number of patient visits required for the conservative, medical, or surgical management of early pregnancy loss in an early pregnancy assessment clinic (EPAC). MethodsA retrospective study of the number of patient visits at an EPAC for conservative, medical, or surgical management of early spontaneous abortion from October 2013 to September 2015 was undertaken. Visits counted included initial assessment, follow-up visits, and surgery date, if separate from a clinic visit. ResultsA total of 945 patients were seen, with 2144 visits during the study period. Conservative management required an average of 3.01 visits (n = 159, median = 3, SD = 1.16, range [1,7]) and misoprostol treatment required an average of 2.51 visits (n = 329, median = 2, SD = 0.83, range [1,6]) to achieve a complete abortion. Dilatation and curettage (D&C) required an average of 1.60 visits (n = 417, median = 1, SD = 0.80, range [1–6]), when including scheduling limitations or an average of 1.13 visits when excluding these limitations. The difference in the number of visits required for the three management options was statistically significant (P < 0.0001). Management with D&C was more likely to require less than two visits to achieve complete abortion compared with the other options (93.8% for D&C vs. 64.5% for misoprostol vs. 37.8% for conservative). ConclusionAn EPAC provides a significant value in the management of early pregnancy losses. There is a significant difference in the total number of visits required for different treatment options. Patients may find this information helpful when considering and deciding upon their preferred treatment option.