Expectant management of incomplete miscarriage and medical management of miscarriage should only be considered where arrangements are in place for follow-up and prompt access to emergency facilities. Appropriate follow-up should be offered to all women having miscarriage. The optimum time for follow-up is around two weeks. Additional later follow-up will be required to review fetal karyotype when performed. Detailed protocols should be established for the investigation of patients with recurrent miscarriage.
Recurrent miscarriage is defined as three clinically confirmed early pregnancy losses.
Similarly, gynaecological units should institute facilities for clinical management and training in laparoscopic treatment of ectopic pregnancy. Recommendations for future research 13. The continued use of therapeutic hCG in the management of recurrent miscarriage can only be justified within the context of randomised clinical trials. Further randomised trials are required to compare the efficacy and acceptability of medical, surgical and expectant management of miscarriage. Furthermore, techniques for surgical evacuation of the uterus need to be assessed, including the role of transvaginal ultrasound at the time of the procedure.