Spontaneous abortion: a randomized, controlled trial comparing surgical evacuation with conservative management using misoprostol
Open accessAbstract
Objective To compare the efficacy of surgical evacuation of the uterus with medical evacuation using misoprostol in cases of spontaneous abortion. Design A prospective, randomized, controlled trial. Setting A university teaching hospital. Patient(s) Six hundred thirty-five women who aborted spontaneously and who consented to pretreatment randomization. Intervention(s) Routine surgical evacuation or medical evacuation of the uterus using misoprostol. Main outcome measure(s) Immediate, short-term (2-3 weeks), and medium-term (6 months) medical complications. Result(s) There was a significantly lower incidence of immediate and short-term complications in the group treated with misoprostol compared with the surgically treated group. There were also fewer major complications in the 6 months after treatment in the medically treated group. Approximately 50% of the medically treated group subsequently required surgical evacuation, and these subjects required significantly more analgesia. Conclusion(s) Treatment with misoprostol can reduce the demand for surgical evacuation in cases of spontaneous abortion, and its use is associated with fewer medical complications.
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Nine randomised controlled trials have compared medical and surgical management of miscarriage.
“Nine randomised controlled trials have compared medical and surgical management.2,8-15”
From Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial) (2006) · cites this paper as [2]
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Lok, I. H., Yip, A. S.-K., Lee, D. T.-S., Sahota, D., & Chung, T. K.-H. (2010) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.12.048 · Cited by 127 · see citing works
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Self-citationPetrou, S., & McIntosh, E. (2009) · Value in Health · doi:10.1111/j.1524-4733.2008.00459.x · Cited by 58 · see citing works
- Authors
- Chung, T. K. H., Lee, D. T. S., Cheung, L. P., Haines, C. J., & Chang, A. M. Z.
- Affiliations
- Chinese University of Hong Kong (HK)
- Corresponding author
- Chung, Tony Kwok Hung
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 1999-06
- Volume
- 71
- Issue
- 6
- Pages
- 1054-1059
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2086983536
- Cited by
- 122
- References
- 0
- Citations by year
- 2025: 2 · 2023: 1 · 2021: 2 · 2020: 4 · 2018: 2 · 2017: 6 · 2016: 3 · 2015: 3 · 2014: 3 · 2013: 5 · 2012: 5
- FWCI
- 9.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Keywords
- miscarriage, misoprostol, medical evacuation, surgical evacuation, uterine evacuation, postpartum complications, analgesia, conservative treatment
- MeSH terms
- Abortifacient Agents, Nonsteroidal, Abortion, Spontaneous, Abortion, Incomplete, Adult, Analgesia, Female, Humans, Postoperative Complications, Pregnancy, Misoprostol
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