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Outcomes of incomplete abortion related to treatment modality

  • General Gynecology
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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

This study evaluated the differences in treatment outcomes between misoprostol and surgical evacuation for the management of incomplete abortion.

Methods

This retrospective cohort study compared patients with a clinical diagnosis of incomplete abortion who underwent surgical or pharmaceutical (misoprostol) intervention, 2014–2017. Demographics, sonographic results, treatment follow-up, and post-intervention data on retained products of conception were retrieved. Women with incomplete abortion who underwent surgical versus pharmaceutical intervention were compared.

Results

Among 589 spontaneous abortions, 198 were included in the study, of which 123 (62.1%) underwent surgical evacuation and 75 (37.9%) pharmaceutical intervention with misoprostol. Baseline characteristics were similar between groups. During 130.8 ± 91.7 days of follow-up, no patient who underwent surgical evacuation had retained products of conception or needed surgical hysteroscopy. Four cases (5.3%) in the misoprostol group had retained products of conception and needed hysteroscopy (p = 0.02). Patients who underwent surgical evacuation had higher hemoglobin levels during follow-up (12.1 mg/dL vs. 11.7 mg/dL, p = 0.05). There were no differences in post-treatment pregnancy rates between groups.

Conclusion

Long-term follow-up after incomplete abortion showed that hemodynamically stable patients treated with misoprostol achieved the desired results in 95% of cases without significant differences in pregnancy intervals compared to surgical management. Further prospective studies with larger sample sizes are required to confirm the outcomes described in this study.

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Data availability

Data available upon request and based on research committee approval.

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Funding

This study was not funded.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Assuta Ashdod University Hospital, Ashdod, Israel

    Merav Sharvit

  2. Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel

    Merav Sharvit

  3. Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel

    Yael Yagur, Yair Daykan, Zvi Klein & Ron Schonman

  4. Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Yael Yagur, Yair Daykan, Zvi Klein & Ron Schonman

  5. Sackler School of Medicine, New York State/American Program of Tel Aviv University, Tel Aviv, Israel

    Rebecca Shams

Authors
  1. Merav Sharvit
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  2. Yael Yagur
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  3. Rebecca Shams
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  4. Yair Daykan
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  5. Zvi Klein
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  6. Ron Schonman
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Contributions

MS: project development, data analysis, manuscript editing. YY: data analysis, manuscript writing and editing. RS: manuscript writing. YD: data analysis, manuscript editing. ZK: data analysis, manuscript editing. RS: conceptualized the project, data analysis, manuscript editing.

Corresponding author

Correspondence to Yael Yagur.

Ethics declarations

Conflict of interest

Author Merav Sharvit declares that she has no conflict of interest. Author Yael Yagur declares that she has no conflict of interest. Author Rebecca Shams declares that she has no conflict of interest. Author Yair Daykan declares that he has no conflict of interest. Author Zvi Klein declares that he has no conflict of interest. Author Ron Schonman declares that he has no conflict of interest.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

According to the retrospective nature of the study conducted, informed consent was not required from the participants.

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Sharvit, M., Yagur, Y., Shams, R. et al. Outcomes of incomplete abortion related to treatment modality. Arch Gynecol Obstet 308, 1543–1548 (2023). https://doi.org/10.1007/s00404-023-07182-7

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  • DOI: https://doi.org/10.1007/s00404-023-07182-7

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