To evaluate whether symptomatology at presentation correlates with successful expectant management of first‐trimester miscarriage.

Data were collected prospectively on women managed expectantly for two weeks with first‐trimester miscarriage. Women diagnosed with incomplete, missed and empty sac miscarriage were included. The overall rate of successful expectant management was evaluated in terms of symptomatology. The rates of successful expectant management for each miscarriage group were also evaluated in terms of the type of symptoms. Main outcome measure was success of expectant management at two weeks.

Spontaneous completion of miscarriage was observed in 76.7% (161/210) women. The overall rates of successful expectant management were significantly different between the symptomatic (79.1%) and asymptomatic (42.9%) groups (P‐value = 0.0003). In the incomplete miscarriage group, higher rates of success were associated with vaginal bleeding than without (89.4 vs 56.3%; P‐value = 0.0027). The presence or absence of pain was not found to be significant.

Symptomatology does appear to be a consistent predictor of outcome for expectant management of miscarriage. Overall, vaginal bleeding at presentation was associated with an increase in success of expectant management; but individually, only significant in the incomplete miscarriage group. The presence or absence of pain at presentation was not a predictor for the various types of miscarriage.