Miscarriage: I am having a miscarriage. How should this be treated? -checksum="54658" ends

Objectives:

Previous research has demonstrated the effectiveness of misoprostol for treatment of incomplete abortion; however, few studies have systematically compared misoprostol's effectiveness with that of standard surgical care. This study documents the effectiveness of a single 600 micrograms dose of oral misoprostol versus manual vacuum aspiration (MVA) for treatment of incomplete abortion in a developing country setting.

Design:

Open-label randomised controlled trial.

Setting:

Two university teaching hospitals in Burkina Faso, West Africa. POPULATION: Women of reproductive age presenting with incomplete abortion.

Methods:

From April 2004 through October 2004, 447 consenting women with incomplete abortion were randomised to either a single dose of 600 micrograms oral misoprostol or MVA for treatment of their condition. MAIN OUTCOME MEASURE: Completed abortion following initial treatment.

Results:

Regardless of treatment assigned, nearly all participants had a complete uterine evacuation (misoprostol = 94.5%, MVA = 99.1%; relative risk [RR] = 0.95 [95% CI 0.92-0.99]). Acceptability and satisfaction ratings were similar and high for both misoprostol and MVA, with three out of four women indicating that the treatment's adverse effects were tolerable (misoprostol = 72.9%, MVA = 75.8%; RR = 0.96 [95% CI 0.86-1.07]). The majority of women were 'satisfied' or 'very satisfied' with the method they received (misoprostol = 96.8%, MVA = 97.7%; RR = 0.99 [95% CI 0.96-1.02]), expressed a desire to choose that method again (misoprostol = 94.5%, MVA = 86.6%; RR = 1.09 [95% CI 1.03-1.16]) and to recommend it to a friend (misoprostol = 94.5%, MVA = 85.2%; RR = 1.11 [95% CI 1.04-1.18]).

Conclusion:

Six hundred micrograms of oral misoprostol is as safe and acceptable as MVA for the treatment of incomplete abortion. Operations research is needed to ascertain the role of misoprostol within postabortion care programmes worldwide.

Related Medical Abstracts - Click on the paper title:-

• Economic evaluation of alternative management methods of first-trimester miscarriage based on results from the MIST trial. (2006-01)
• Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial). (2006-02)
• Expectant care versus surgical treatment for miscarriage. (2006-03)
• Expectant, medical, or surgical management of first-trimester miscarriage: a meta-analysis. (2005-01)
• A randomised trial of surgical, medical and expectant management of first trimester spontaneous miscarriage. (2005-02)
• A randomized controlled trial comparing medical and expectant management of first trimester miscarriage. (2004-01)
• Expectant management of early pregnancies of unknown location: A prospective evaluation of methods to predict spontaneous resolution of pregnancy (2001)
• The treatment of incomplete miscarriage with oral misoprostol (2001)Randomised trial comparing expectant with medical management for first trimester miscarriages. (1999)
• Early pregnancy assessment; A role for the gynaecology nurse-practitioner. (1999)Expectant management of missed miscarriage. (1998)
• Randomised trial of expectant versus surgical management of spontaneous miscarriage (1997)
• Expectant management versus elective curettage for the treatment of spontaneous abortion (1997)
• The spontaneous pregnancy prognosis in untreated subfertile couples: The Walcheren primary care study. (1997)
• Expectant management versus elective curettage for the treatment of spontaneous abortion. (1997)

Please click on the required question.

• 1  What is a miscarriage?
• 2  What are the different types of miscarriage?
• 3  How accurate are pregnancy tests?
• 4 What is a blighted ovum?
• 5 I have had a hydatidiform mole. What is this?
• 6 Why did I have a spontaneous miscarriage?
• 7 How frequently do miscarriages occur?
• 8 I am miscarrying. How should this be treated?
• 8a Can miscarriage result in anxiety and depression?
•  9 What is meant by recurrent miscarriage?
• 10 I have a problem with recurrent miscarriage. What is the chance of my next pregnancy being successful?
• Q 12.11 Recurrent Miscarriage I have miscarried again. Why does this keep happening?
• 12 What congenital problems might be associated with recurrent miscarriage and how could they be treated?
• 13 What traumatic conditions can cause recurrent miscarriage and how can they be treated?
• 14 Can infection cause recurrent miscarriage and would treatment help?
• 15 Could a metabolic disorder cause recurrent miscarriage?
• 16 Could a hormonal problem account for recurrent miscarriage and would hormone treatment help me?
• 17 Could an autoimmune problem cause recurrent miscarriage and how could this be treated?
• 18 Could a tumour cause recurrent miscarriage?
• 19 What degenerative processes may be associated with recurrent miscarriage?
• 20 After every miscarriage I become more depressed. Could this account for the problem?
• 21 Is it always possible to explain recurrent miscarriage?
• 22 I have a problem with recurrent miscarriage. What treatment is available to ensure that this does not happen again?
• 23 What is an ectopic pregnancy?
• 24 How frequently do ectopic pregnancies occur?
• 25 Why do ectopic pregnancies occur?
• 26 How can an ectopic pregnancy be diagnosed?
• 27 How can an ectopic pregnancy be treated?
• 28 Where can I obtain more information?
• 29 Support Groups.
  

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.