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MisoREST: Surgical versus expectant management in women with an incomplete evacuation of the uterus after misoprostol treatment for miscarriage: A cohort study.
Lemmers, Marike; Verschoor, Marianne A C; Oude Rengerink, Katrien; Naaktgeboren, Christiana; Bossuyt, Patrick M; Huirne, Judith A F; Janssen, Ineke A H; Radder, Celine; Klinkert, Ellen R; Langenveld, Josje; van der Voet, Lucet; Siemens, F Frederike; Bongers, Marlies Y; van Hooff, Marcel H; van der Ploeg, Marinus; Sjors, F P J; Coppus, S F P J; Ankum, W M; Mol, Ben Willem J.
Afiliación
  • Lemmers M; Department of Obstetrics and Gynaecology, Academic Medical Center, P.O. Box 22770, 1100 DE Amsterdam, The Netherlands; Department of Obstetrics and Gynaecology, VU Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. Electronic address: m.lemmers@amc.uva.nl.
  • Verschoor MAC; Department of Obstetrics and Gynaecology, Academic Medical Center, P.O. Box 22770, 1100 DE Amsterdam, The Netherlands.
  • Oude Rengerink K; Julius Center for Health Sciences and Primary Care, UMC Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
  • Naaktgeboren C; Julius Center for Health Sciences and Primary Care, UMC Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
  • Bossuyt PM; Clinical Research Unit, University of Amsterdam, Academic Medical Center, P.O. Box 22770, 1100 DE Amsterdam, The Netherlands.
  • Huirne JAF; Department of Obstetrics and Gynaecology, VU Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
  • Janssen IAH; Department of Obstetrics and Gynaecology, Groene Hart Ziekenhuis, P.O. Box 1098, 2800 BB Gouda, The Netherlands.
  • Radder C; Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis West, P.O. Box 9243, 1006 AE Amsterdam, The Netherlands.
  • Klinkert ER; Department of Obstetrics and Gynaecology, University Medical Center Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands.
  • Langenveld J; Department of Obstetrics and Gynaecology, Atrium Medical Center, P.O. Box 4446, 6401 CX Heerlen, The Netherlands.
  • van der Voet L; Department of Obstetrics and Gynaecology, Deventer Hospital, P.O. Box 5001, 7400 GC Deventer, The Netherlands.
  • Siemens FF; Department of Obstetrics and Gynaecology, Reinier de Graaf Hospital, P.O. Box 5011, 2600 GA Delft, The Netherlands.
  • Bongers MY; Department of Obstetrics and Gynaecology, Maxima Medical Center, Postbus 7777, 5500 MB Veldhoven, The Netherlands.
  • van Hooff MH; Department of Obstetrics and Gynaecology, Sint Franciscus Gasthuis, Rotterdam, P.O. Box 10900, 3004 BA Rotterdam, The Netherlands.
  • van der Ploeg M; Department of Obstetrics and Gynaecology, Martini ziekenhuis Groningen, P.O Box 30033, 9700 RM Groningen, The Netherlands.
  • Sjors FPJ; Department of Obstetrics and Gynaecology,UMC St. Radboud, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
  • Coppus SFPJ; Department of Obstetrics and Gynaecology,UMC St. Radboud, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
  • Ankum WM; Department of Obstetrics and Gynaecology, Academic Medical Center, P.O. Box 22770, 1100 DE Amsterdam, The Netherlands.
  • Mol BWJ; The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, 55 King William Road, North Adelaide SA 5006 and The South Australian Health and Medical Research Institute, Adelaide, Australia.
Eur J Obstet Gynecol Reprod Biol ; 211: 83-89, 2017 Apr.
Article en En | MEDLINE | ID: mdl-28209537
OBJECTIVE: To assess the effectiveness of curettage versus expectant management in women with an incomplete evacuation of the uterus after misoprostol treatment for first trimester miscarriage. STUDY DESIGN: We conducted a multicenter cohort study alongside a randomized clinical trial (RCT) between June 2012 until July 2014. 27 Dutch hospitals participated. Women with an incomplete evacuation after misoprostol treatment for first trimester miscarriage who declined to participate in the RCT, received treatment of their preference; curettage (n=65) or expectant management (n=132). A successful outcome was defined as an empty uterus on sonography at six weeks or uneventful clinical follow-up. We furthermore assessed complication rate and (re)intervention rate RESULTS: Of the 197 women who declined to participate in the RCT, 65 preferred curettage and 132 expectant management. A successful outcome was observed in 62/65 women (95%) in the surgical group versus 112/132 women (85%) in the expectant group (RR 1.1, 95% CI 1.03-1.2), with complication rates of 6.2% versus 2.3%, respectively (RR 2.7, 95% CI 0.6-12). CONCLUSION: In women with an incomplete evacuation of the uterus after misoprostol treatment, expectant management is an effective and safe option. This finding could restrain the use of curettage in women that have used misoprostol in the treatment of first trimester miscarriage.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Abortivos no Esteroideos / Aborto Espontáneo / Aborto Incompleto / Misoprostol / Dilatación y Legrado Uterino / Espera Vigilante Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Eur J Obstet Gynecol Reprod Biol Año: 2017 Tipo del documento: Article Pais de publicación: Irlanda
Texto completo
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PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Abortivos no Esteroideos / Aborto Espontáneo / Aborto Incompleto / Misoprostol / Dilatación y Legrado Uterino / Espera Vigilante Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Eur J Obstet Gynecol Reprod Biol Año: 2017 Tipo del documento: Article Pais de publicación: Irlanda