In:
Obstetrics and Gynecology International, Hindawi Limited, Vol. 2014 ( 2014), p. 1-6
Abstract:
Objectives . To survey practice variation in the management of first trimester miscarriage in The Netherlands. Methods . We sent an online questionnaire to gynecologists in eight academic, 37 nonacademic teaching, and 47 nonteaching hospitals. Main outcome measures were availability of a local protocol; estimated number of patients treated with curettage, misoprostol, or expectant management; misoprostol regimen; and estimated number of curettages performed after initial misoprostol treatment. Outcomes were compared to the results of a previous nationwide survey. Results . The response rate was 100%. A miscarriage protocol was present in all academic hospitals, 68% of nonacademic teaching hospitals, and 38% of nonteaching hospitals ( P = 0.008 ). Misoprostol was first-choice treatment for 41% of patients in academic hospitals versus 34% and 27% in teaching-and nonteaching hospitals ( P = 0.045 ). There were 23 different misoprostol regimens. Curettage was first-choice treatment in 29% of patients in academic hospitals versus 46% and 50% in nonacademic teaching or nonteaching hospitals ( P = 0.007 ). In 30% of patients, initial misoprostol treatment was followed by curettage. Conclusions . Although the percentage of gynaecologists who are aware of the availability of misoprostol for miscarriage treatment has doubled to almost 100% since 2005, practice variation is still large. This practice variation underlines the need for a national guideline.
Type of Medium:
Online Resource
ISSN:
1687-9589
,
1687-9597
Language:
English
Publisher:
Hindawi Limited
Publication Date:
2014
detail.hit.zdb_id:
2495157-2
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