Missed abortion is defined as unrecognized intrauterine death of the embryo or fetus without expulsion of the products of conception. It constitutes approximately 15% of clinically diagnosed pregnancies. Women experiencing a missed abortion may have no self-awareness due to the lack of obvious symptoms. With around 95% success rate, surgical evacuation is regarded as the standard treatment for missed abortion, which had been widely performed all over the world in the past 50 years. However, the costs of surgery and hospitalization, as well as the complications associated with surgery and anesthesia are a major unresolved concern. Besides infection and bleeding, decreased fertility caused by intrauterine adhesions may be unacceptable for women with missed abortions, who have not yet fulfilled their motherhood desires. Some studies have thus suggested that expectant or medical management might be more suitable instead of surgical evacuation. Expectant management has been reported with an unpredictable success rate ranging from 25–76%. Waiting for spontaneous expulsion of the products of conception would waste much time, during which women may suffer uncertainty and anxiety. When additional surgical evacuation is needed owing to failure, they may suffer from an emotional breakdown. It is thus not recommended for missed early miscarriage due to the risks of emergency surgical treatment and blood transfusion.
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