Management of early pregnancy loss

G. C.M. Graziosi*, B. W. Mol, W. M. Ankum, H. W. Bruinse

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

48 Citations (Scopus)


Objectives: In order to assess the available evidence on the management of early pregnancy loss, we performed a meta-analysis on the subject. Methods: MEDLINE and EMBASE were searched for randomized studies reporting on the effectiveness of expectant management, misoprostol treatment or curettage. Outcomes considered were 'complete evacuation', complications, duration of bleeding, pain resulting from the procedure, side effects and women's satisfaction with the procedure. Results: Thirteen studies were identified. Combined data in women with missed abortion managed expectantly or treated with misoprostol showed complete evacuation rates of 28% (49/173) (range 14-47%) and 81% (242/298) (range 60-83%), respectively. In women with incomplete abortion, these rates were 94% (31/33) (range 80-100%) and 99% (75/76) (range 99-100%), respectively. Conclusion: In the management of early pregnancy loss both expectant management and misoprostol treatment reduce the need for curettage, but misoprostol treatment seems to be more effective in women with missed abortion as compared to expectant management.

Original languageEnglish
Pages (from-to)337-346
Number of pages10
JournalInternational Journal of Gynecology and Obstetrics
Issue number3
Publication statusPublished - Sept 2004


  • Curettage
  • Early pregnancy loss
  • Expectant management
  • Meta-analysis
  • Misoprostol


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