[Does the '(Imminent) miscarriage standard of the Dutch College of Family Physicians correspond to the management by gynecologists?].

OBJECTIVE

To determine if the '(Imminent) miscarriage' standard issued by the Dutch College of General Practitioners corresponds to the management by obstetricians.

DESIGN

Postal questionnaire.

SETTING

Research Centre Primary/Secondary Health Care, Free University Hospital Amsterdam.

METHOD

A postal questionnaire was sent in 1994 to all partnerships of obstetricians (n = 122) in the Netherlands about their management in case of an imminent miscarriage.

RESULTS

The response rate was 86% (n = 105). Nearly all partnerships (94%) had an agreement about their management in case of an imminent miscarriage, but the individual protocols varied. In case of a miscarriage or an imminent miscarriage 10% and 28% respectively of all partnerships said they would refer the woman to the GP or midwife. Furthermore, 21% of all partnerships said that the GP or midwife could not have an ultrasound scan made themselves, i.e. without referring to the obstetrician. Many respondent knowing the GP standard (64%) did not agree with the guidelines restricting ultrasound scans (39%) or advising expectative management (24%). They thought that an ultrasound scan was essential to diagnosis and that an expectative management would increase the risk of severe blood loss. On the other hand 15% agreed to all the guidelines.

CONCLUSION

The management of obstetricians with respect to (imminent) miscarriage is diverse and does not correspond to the guidelines of the '(Imminent) miscarriage' GP standard, notably with respect to the advised expectative management.