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Research

Incidence of pregnancy after expectant, medical, or surgical management of spontaneous first trimester miscarriage: long term follow-up of miscarriage treatment (MIST) randomised controlled trial

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b3827 (Published 08 October 2009) Cite this as: BMJ 2009;339:b3827

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It is a known fact that attainment of fertility is poor in old women and recurrent spontaneous abortions

It ia universally known fact that the perimenopausal and older women
may grow infertile, as the fertility declines with age. Similarly, it is a
well established fact that recurrent spontaneous abortions has a poor
pregnancy outcome. The MIST study has concluded the same1. In my opinion
these two categories could have been excluded while recruiting the
subjects as these are big confounders. Or age could have been stratified
while interpreting the data. Nevertheless, the MIST study tells us about
the prognosis in terms of occurence of pregnancy after spontaneous first
trimester miscarriages which is 84%, irrespective of modality of
management (expectant, medical or surgical). Further, the data should have
been interpreted in terms of parity also, especially for primipara and
grand multipara.

Reference:

1. Smith LFP and Ewings PD. Incidence of pregnancy after ezxpectant,
medical or surgical mangement of spontaneous first trimester
miscarrige:long term follow-up of miscarriage treatment (MIST)randomised
controlled trial. BMJ 2009,339.b3827

Competing interests:
None declared

Competing interests: No competing interests

09 October 2009
Neeru Gupta
Deputy Director General and Scientist E
Indian Council of Medical Research, Ansari Nagar, New Delhi-110029.
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