Imperial College London
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ProfessorLesleyRegan

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Clinical Professor
 
 
 
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Contact

 

+44 (0)20 3312 1798l.regan

 
 
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Assistant

 

Ms Hazel Blackman +44 (0)20 7594 2104

 
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Location

 

MWG022Mint WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Coomarasamy:2021:10.1016/S0140-6736(21)00683-8,
author = {Coomarasamy, A and Gallos, ID and Papadopoulou, A and Dhillon-Smith, RK and Al-Memar, M and Brewin, J and Christiansen, OB and Stephenson, MD and Oladapo, OT and Wijeyaratne, CN and Small, R and Bennett, PR and Regan, L and Goddijn, M and Devall, AJ and Bourne, T and Brosens, JJ and Quenby, S},
doi = {10.1016/S0140-6736(21)00683-8},
journal = {The Lancet},
pages = {1668--1674},
title = {Sporadic miscarriage: evidence to provide effective care},
url = {http://dx.doi.org/10.1016/S0140-6736(21)00683-8},
volume = {397},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - The physical and psychological effect of miscarriage is commonly underappreciated. The journey from diagnosis of miscarriage, through clinical management, to supportive aftercare can be challenging for women, their partners, and caregivers. Diagnostic challenges can lead to delayed or ineffective care and increased anxiety. Inaccurate diagnosis of a miscarriage can result in the unintended termination of a wanted pregnancy. Uncertainty about the therapeutic effects of interventions can lead to suboptimal care, with variations across facilities and countries. For this Series paper, we have developed recommendations for practice from a literature review, appraisal of guidelines, and expert group discussions. The recommendations are grouped into three categories: (1) diagnosis of miscarriage, (2) prevention of miscarriage in women with early pregnancy bleeding, and (3) management of miscarriage. We recommend that every country reports annual aggregate miscarriage data, similarly to the reporting of stillbirth. Early pregnancy services need to focus on providing an effective ultrasound service, as it is central to the diagnosis of miscarriage, and be able to provide expectant management of miscarriage, medical management with mifepristone and misoprostol, and surgical management with manual vacuum aspiration. Women with the dual risk factors of early pregnancy bleeding and a history of previous miscarriage can be recommended vaginal micronised progesterone to improve the prospects of livebirth. We urge health-care funders and providers to invest in early pregnancy care, with specific focus on training for clinical nurse specialists and doctors to provide comprehensive miscarriage care within the setting of dedicated early pregnancy units.
AU  - Coomarasamy,A
AU  - Gallos,ID
AU  - Papadopoulou,A
AU  - Dhillon-Smith,RK
AU  - Al-Memar,M
AU  - Brewin,J
AU  - Christiansen,OB
AU  - Stephenson,MD
AU  - Oladapo,OT
AU  - Wijeyaratne,CN
AU  - Small,R
AU  - Bennett,PR
AU  - Regan,L
AU  - Goddijn,M
AU  - Devall,AJ
AU  - Bourne,T
AU  - Brosens,JJ
AU  - Quenby,S
DO  - 10.1016/S0140-6736(21)00683-8
EP  - 1674
PY  - 2021///
SN  - 0140-6736
SP  - 1668
TI  - Sporadic miscarriage: evidence to provide effective care
T2  - The Lancet
UR  - http://dx.doi.org/10.1016/S0140-6736(21)00683-8
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33915095
UR  - https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00683-8/fulltext
UR  - http://hdl.handle.net/10044/1/92088
VL  - 397
ER  -
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