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Miscarriage (spontaneous pregnancy loss at less than 14 weeks’ gestation) is
common. The need for routine surgical evacuation for miscarriage has been questioned
because of potential complications such as cervical trauma, uterine perforation,
haemorrhage, or infection.
Key messages
􀃎 Expectant management led to a higher risk of incomplete miscarriage, need
for surgical emptying of the uterus, and bleeding. In contrast, surgical
evacuation was associated with a significantly higher risk of infection.
􀃎 The evidence is not enough to support a policy of routine surgical evacuation
for spontaneous miscarriage.
􀃎 Given the equivocal evidence, the woman’s preference should play a dominant
role in decision making.


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