TY - JOUR
T1 - Misoprostol versus curettage in women with early pregnancy failure after initial expectant management
T2 - A randomized trial
AU - Graziosi, G. C.M.
AU - Mol, B. W.J.
AU - Reuwer, P. J.H.
AU - Drogtrop, A.
AU - Bruinse, H. W.
PY - 2004/1/1
Y1 - 2004/1/1
N2 - Background: Little is known about the effectiveness of misoprostol treatment in women with early pregnancy failure who have been managed expectantly. We therefore performed a randomized trial on this subject. Methods: Women with early pregnancy failure, who had been managed expectantly for at least 1 week, were assigned randomly (using a computer-generated list) to receive either vaginal misoprostol 800 μg or curettage. If, after 24 h, there had not been complete evacuation, a further 800 μg of misoprostol was administered. In the absence of complete evacuation after >3 days, curettage was performed. The primary end-point was the complete evacuation of the products of conception, with secondary end-points being the occurrence of side effects, pain intensity, need for analgesics, and intensity and duration of bleeding. Results: In the misoprostol group, 47% (37/79) required curettage due to incomplete evacuation. After 1 week, evacuation was complete in 85% (67 out of 79) of the misoprostol group and 93% (70 out of 75) of the turettage group. Severity of pain, bleeding and emergency evacuation was higher in the misoprostol group. The complication rate was 0% for misoprostol and 4% for curettage. Conclusions: Curettage is superior to misoprostol in the evacuation of early pregnancy failure after failed expectant management. However, misoprostol could be clinically useful since it reduces the need for curettage by half and has a lower complication rate, at the expense of increased paih, vaginal bleeding and emergency evacuation.
AB - Background: Little is known about the effectiveness of misoprostol treatment in women with early pregnancy failure who have been managed expectantly. We therefore performed a randomized trial on this subject. Methods: Women with early pregnancy failure, who had been managed expectantly for at least 1 week, were assigned randomly (using a computer-generated list) to receive either vaginal misoprostol 800 μg or curettage. If, after 24 h, there had not been complete evacuation, a further 800 μg of misoprostol was administered. In the absence of complete evacuation after >3 days, curettage was performed. The primary end-point was the complete evacuation of the products of conception, with secondary end-points being the occurrence of side effects, pain intensity, need for analgesics, and intensity and duration of bleeding. Results: In the misoprostol group, 47% (37/79) required curettage due to incomplete evacuation. After 1 week, evacuation was complete in 85% (67 out of 79) of the misoprostol group and 93% (70 out of 75) of the turettage group. Severity of pain, bleeding and emergency evacuation was higher in the misoprostol group. The complication rate was 0% for misoprostol and 4% for curettage. Conclusions: Curettage is superior to misoprostol in the evacuation of early pregnancy failure after failed expectant management. However, misoprostol could be clinically useful since it reduces the need for curettage by half and has a lower complication rate, at the expense of increased paih, vaginal bleeding and emergency evacuation.
KW - Curettage
KW - Early pregnancy failure
KW - Expectant management
KW - Misoprostol
KW - Randomized trial
UR - http://www.scopus.com/inward/record.url?scp=4344690269&partnerID=8YFLogxK
U2 - 10.1093/humrep/deh344
DO - 10.1093/humrep/deh344
M3 - Article
C2 - 15192065
AN - SCOPUS:4344690269
SN - 0268-1161
VL - 19
SP - 1894
EP - 1899
JO - Human Reproduction
JF - Human Reproduction
IS - 8
ER -