BMJ  2006;332:1223-1224 (27 May), doi:10.1136/bmj.332.7552.1223

Editorial

Spontaneous miscarriage in the first trimester

Let each patient choose among expectant, surgical, or medical management

The first 150 words of the full text of this article appear below.

Miscarriage in the first trimester affects about 15% of all pregnancies. It can be classified into early fetal loss (previously called missed abortion or blighted ovum) and retained products of conception (previously called incomplete abortion). Traditionally, both types of first trimester miscarriage are treated by surgical uterine evacuation. Increasingly, however, women are offered medical management (using misoprostol) or expectant management (avoiding treatment and letting the miscarriage take its natural course).

There have been numerous studies of miscarriage management, but they have generally been underpowered to assess anything other than the need for unplanned uterine curettage.¹² The miscarriage treatment (MIST) study, a large, multicentre, randomised trial reported by Trinder and colleagues on p 1235, is therefore welcome.³

In the MIST study 1200 women with early fetal loss or retained products of conception were randomly allocated to receive expectant, surgical, or medical management. The primary outcome was infection, and there was . . . [Full text of this article]

(aweeks@liv.ac.uk), School of Reproductive and Developmental Medicine, Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS

Department of Woman and Child Health, Division for Obstetrics and Gynaecology, Karolinska Institutet, S-171 76 Stockholm, Sweden

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial)

J Trinder, P Brocklehurst, R Porter, M Read, S Vyas, and L Smith
BMJ 2006 332: 1235-1240. [Abstract] [Full Text] [PDF]

Outcome of expectant management of spontaneous first trimester miscarriage: observational study

Ciro Luise, Karen Jermy, Caroline May, Gillian Costello, William P Collins, and Thomas H Bourne
BMJ 2002 324: 873-875. [Abstract] [Full Text] [PDF]

Intracranial hypertension and nasal fluticasone propionate

Michael Oko, Andrew Johnston, and Iain R C Swan
BMJ 2001 323: 694. [Extract] [Full Text]

This article has been cited by other articles:

• (2006). Is Surgical Management Required After Miscarriage?. JWatch General 2006: 6-6 [Full text]  

Rapid Responses:

Read all Rapid Responses

Success of medical management of miscarriage is better assessed 2 weeks post-treatment

Arabinda Saha, et al.
bmj.com, 26 Aug 2006 [Full text]

Online poll

Find out more >>