Spontaneous abortion: a randomized, controlled trial comparing surgical evacuation with conservative management using misoprostol.
OBJECTIVE
To compare the efficacy of surgical evacuation of the uterus with medical evacuation using misoprostol in cases of spontaneous abortion.


METHODS
A prospective, randomized, controlled trial.


METHODS
A university teaching hospital.


METHODS
Six hundred thirty-five women who aborted spontaneously and who consented to pretreatment randomization.


METHODS
Routine surgical evacuation or medical evacuation of the uterus using misoprostol.


METHODS
Immediate, short-term (2-3 weeks), and medium-term (6 months) medical complications.


RESULTS
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.


CONCLUSIONS
Treatment with misoprostol can reduce the demand for surgical evacuation in cases of spontaneous abortion, and its use is associated with fewer medical complications.
Chung
T K
TK
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, NT. tonychung@cuhk.edu.hk
Lee
D T
DT
Cheung
L P
LP
Haines
C J
CJ
Chang
A M
AM
D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects / Q000627:therapeutic use; D000027:Abortion, Incomplete / Q000188:drug therapy / Q000601:surgery; D000022:Abortion, Spontaneous / Q000188:drug therapy* / Q000601:surgery*; D000328:Adult; D000698:Analgesia; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000009:adverse effects / Q000627:therapeutic use*; D011183:Postoperative Complications; D011247:Pregnancy
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol