Spontaneous abortions of first trimester pregnancy: manual vacuum aspiration is still on line?

Spontaneous abortions of first trimester pregnancy is a frequent pathology in gynecology (more than 10% of clinical pregnancy). Since the midth of twentieth century, the gold standard of evacuation of spontaneous abortion is manual vacuum aspiration most of the time under general anesthesia. This method is used in France for all miscarriages after 7 weeks’ gestation at the sonography (about 40 000 women in 1999) but complications are not rare. The vaginal sonography and new medical management changes the view. We can now use expectative management or medical management with misoprostol and/or mifepristone. We summarise the current literature and propose a randomised multicentric control trial. [Copyright &y& Elsevier]