Which approach for first trimester miscarriage?

Around 15% of all known pregnancies miscarry during the first trimester. Historically, first trimester miscarriage was managed surgically to remove all retained products of conception, with the aim of minimising the likelihood of blood loss and infection from retained tissue. Nowadays, medical management (use of drugs such as mifepristone and misoprostol) and expectant management (i.e. allowing the miscarriage to conclude naturally) have become alternatives to a surgical procedure for managing women with early miscarriage. Here, we review the evidence on these three methods to assess the benefits and disadvantages of each.