title: Quality of life and acceptability of medical versus surgical management of early pregnancy failure.
abstract: OBJECTIVE
  This study compares quality of life (QOL) and acceptability of medical versus surgical treatment of early pregnancy failure (EPF).
  
  
  METHODS
  A randomised clinical trial of treatment for EPF compared misoprostol vaginally versus vacuum aspiration (VA).
  
  
  METHODS
  A multisite trial at four US Urban University Hospitals.
  
  
  METHODS
  A total of 652 women with an EPF were randomised to treatment.
  
  
  METHODS
  Participants completed a daily symptom diary and a questionnaire 2 weeks after treatment.
  
  
  METHODS
  The questionnaire assessment included subscales of the Short Form-36 Health Survey Revised for QOL and measures of wellbeing, recovery difficulties, and treatment acceptability.
  
  
  RESULTS
  The two groups did not differ in mean scores for QOL except bodily pain; medical treatment was associated with higher levels of bodily pain than VA (P < 0.001). Success of treatment was not related to QOL, but acceptability of the procedure was decreased for medical therapy if unsuccessful (P = 0.003). Type of treatment was not associated with differences in recovery, and the two groups reported similar acceptability except for cramping (P = 0.02), bleeding (P < 0.001), and symptom duration (P = 0.03).
  
  
  CONCLUSIONS
  Despite reporting greater pain and lower acceptability of treatment-related symptoms, QOL and treatment acceptability were similar for medical and surgical treatment of EPF. Acceptability, but not QOL, was influenced by success or failure of medical management.
authors.affiliation: Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA. brynah@uic.edu
authors.forename: B
authors.initials: B
authors.lastname: Harwood
authors.forename: T
authors.initials: T
authors.lastname: Nansel
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000379:methods*; D000022:Abortion, Spontaneous; D000282:Administration, Intravaginal; D000328:Adult; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D017060:Patient Satisfaction; D011247:Pregnancy; D011788:Quality of Life; D014619:Vacuum Curettage / Q000379:methods*
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol