期刊
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
卷 206, 期 3, 页码 -出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2011.12.009
关键词
expectant management; mifepristone; miscarriage; misoprostol; randomized trial
资金
- Assistance Publique-Hopitaux de Paris
OBJECTIVE: To compare immediate vs delayed medical treatment for first-trimester miscarriage. STUDY DESIGN: Randomized open-label trial in a university hospital gynecologic emergency department. Between April 2003 and April 2006, 182 women diagnosed with spontaneous abortion before 14 weeks' gestation were assigned to immediate medical treatment (oral mifepristone, followed 48 hours later by vaginal misoprostol, n = 91) or sequential management (1 week of watchful waiting followed, if necessary, by the above-described medical treatment, n = 91). Vacuum aspiration was performed in case of treatment failure, hemorrhage, pain, infection, or patient request. RESULTS: Compared with immediate medical treatment, sequential management resulted in twice as many vacuum aspirations overall (43.5% vs 19.1%; P = .001), 4 times as many emergent vacuum aspirations (20% vs 4.5%; P = .001), and twice as many unplanned visits to the emergency department (34.1% vs 16.9%; P = .009). CONCLUSION: Delaying medical treatment of first-trimester miscarriage increases the rate of unplanned surgical uterine evacuation.
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