A randomized study comparing efficacy and patient satisfaction in medical or surgical treatment of miscarriage.
OBJECTIVE
To compare the efficacy of the medical treatment to surgical uterine evacuation and patient satisfaction in each group.


METHODS
A randomized, controlled study.


METHODS
An outpatient clinic in the Department of Gynecology and Obstetrics in Oulu University Hospital, Oulu, Finland.


METHODS
Ninety-eight eligible women who had had miscarriages.


METHODS
Medical treatment of miscarriage (n = 49) with 200 mg of mifepristone and 0.8 mg of misoprostol 1-3 days after the event or surgical uterine evacuation (n = 49). Questionnaires to collect data of experienced pain and patient satisfaction.


METHODS
The complete abortion rate with the primary treatment (primary outcome) and the patient satisfaction (secondary outcome).


RESULTS
The success rate was equal (100% in surgical and 90% in medical group). More infections were diagnosed in the surgical group. Surgically treated patients were more satisfied with the treatment (100% vs. 88%). Medical treatment was considered more painful and fewer patients (70% vs. 91%) would choose the medical method in the future.


CONCLUSIONS
Medical treatment is an effective alternative to surgical treatment and increases the choice available to women. Surgical treatment is associated with more infections. More medically treated patients experienced pain and dissatisfaction.
Niinimäki
Maarit
M
Department of Gynecology and Obstetrics, Oulu University Hospital, Oulu, Finland. maarit.niinimaki@oulu.fi
Jouppila
Pentti
P
Martikainen
Hannu
H
Talvensaari-Mattila
Anne
A
D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000021:Abortifacient Agents, Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000022:Abortion, Spontaneous / Q000188:drug therapy* / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology / Q000209:etiology; D015735:Mifepristone / Q000009:adverse effects / Q000627:therapeutic use*; D016595:Misoprostol / Q000009:adverse effects / Q000627:therapeutic use*; D010146:Pain / Q000139:chemically induced; D017060:Patient Satisfaction; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D016896:Treatment Outcome; D014619:Vacuum Curettage / Q000009:adverse effects
D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone