General Obstetrics and GynecologyA comparison of the psychologic impact and client satisfaction of surgical treatment with medical treatment of spontaneous abortion: A randomized controlled trial*,**
Section snippets
Material and methods
Two hundred eighteen women who were admitted to the gynecologic unit from October 1995 through June 1996 with a clinical diagnosis of spontaneous abortion, a positive urinary pregnancy test, and transvaginal sonographic evidence of retained products of conception (POCs) were asked to consent for randomization before treatment. Informed consent was obtained according to a research protocol approved by the Clinical Trials Ethics Committee. Participants were excluded from randomization if they had
Participants
During the study period, 784 patients were admitted for spontaneous abortions to the unit and were therefore potentially eligible for recruitment. However, recruitment for the study occurred only during week days when 570 patients were admitted. Of these, 48 women were not considered because, in the opinion of the attending doctor, there were medical reasons that they should not be randomized. Two hundred sixty-seven women declined participation, and a further 37 women were not approached by
Comments
The results of this study show that a more conservative approach to the treatment of spontaneous abortion, as detailed in the misoprostol protocol, is psychologically safe and generally acceptable to the participants. Women who were treated with the misoprostol protocol were similar to women who were treated with a conventional surgical approach (in terms of short- and medium-term psychologic well-being and depression), as reflected by the 6-week and 6-month GHQ and BDI scores. The SCID
Acknowledgements
We thank M. O'Hara for his comments and suggestions.
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Cited by (37)
Surgical management of a loss of pregnancy in the first trimester: Patient experience and influencing factors, a prospective observational study
2023, Journal of Gynecology Obstetrics and Human ReproductionMisoREST: Surgical versus expectant management in women with an incomplete evacuation of the uterus after misoprostol treatment for miscarriage: A cohort study
2017, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :Despite this, we found expectant management very often to be successful. Several other studies reporting on women with miscarriages also found strong patient preferences for either curettage or expectant management [10,20–28]. Due to the fact that women chose their treatment of preference, selection bias cannot be excluded.
Medical treatment of spontaneous abortion in the first trimester
2015, Clinica e Investigacion en Ginecologia y ObstetriciaCounseling women with early pregnancy failure: Utilizing evidence, preserving preference
2010, Patient Education and CounselingCitation Excerpt :In a similar fashion, we examine options for EPF management through this lens. All four treatment options have similar profiles for safety, subsequent conception, and patient acceptability [7,8,12,14–17,27–30]. Surgical management has very high success rates while aggregate efficacy data from clinical trials show wide ranges of treatment success for both expectant and medical management [7,8,12,14,15,27–29,31–34].
Diagnosis and management of first-trimester complications
2008, Family Medicine ObstetricsClinical indicators for success of misoprostol treatment after early pregnancy failure
2007, International Journal of Gynecology and ObstetricsCitation Excerpt :Recently, medical management of early pregnancy failure with misoprostol, a synthetic prostaglandin E1 analogue, has been shown to be effective, safe, and convenient [3]. It has the same or an even higher acceptability rate as surgical treatment for early pregnancy loss [4,5]. In most previous research studies, transvaginal ultrasonography was used to verify the expulsion of the products of conception after medical management with misoprostol.
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Supported by the Health Services Research Fund of Hong Kong Hospital Authority, Hong Kong (grant number 511007).
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Reprint requests: Dominic T. S. Lee, MD, Department of Psychiatry, The Chinese University of Hong Kong, Sha Tin, NT, Hong Kong, China. E-mail: [email protected].