Expectant Management

Definition - What does Expectant Management mean?

The term expectant management is a period of 'watchful waiting' without any active intervention. During pregnancy, watchful waiting enables the process to take its natural course with the woman going into spontaneous labor or requiring induction of labor at a future date. While undergoing expectant management, the baby and mother are closely monitored for any signs of distress and complications. The 'watch and wait' protocol is also followed when a woman sustains a miscarriage in her first trimester, or sometimes when the embryo implants outside the uterus.

FertilitySmarts explains Expectant Management

During pregnancy, expectant management is most appropriate in the following situations:

  • First-trimester miscarriage: A majority of the women with a first-trimester miscarriage who undergo expectant management are able to pass the entire tissue within 2 to 6 weeks without any significant complication than that from surgical intervention
  • Ectopic pregnancy: a) The woman appears physically stable, b) The primary pregnancy hormone (beta-hCG) levels are still on the lower side, c) Pain score is determined to be tolerable, d) There is no evidence of complications, including bleeding into the abdomen
  • When the bag of waters breaks before 32 weeks of pregnancy (a condition referred to as preterm premature rupture of the membranes: Around 80% of women experience spontaneous labor within 48 hours of expectant therapy before 32 weeks of pregnancy
  • In pregnant women with conditions like preeclampsia and diabetes, who haven't yet reached term (the normal 37 weeks of pregnancy) as the lungs of the unborn baby are still immature, and the cervix of the woman is not sufficiently prepared for delivery of a newborn child. Delivering a baby in these instances often leads to greater complications than that associated with watchful waiting
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