The medical management of missed miscarriage: outcomes from a prospective, single-centre, Australian cohort

Petersen, Scott G., Perkins, Anneliese R., Gibbons, Kristen S., Bertolone, Julia I. and Mahomed, Kassam (2013) The medical management of missed miscarriage: outcomes from a prospective, single-centre, Australian cohort. Medical Journal of Australia, 199 5: 341-346. doi:10.5694/mja12.11813


Author Petersen, Scott G.
Perkins, Anneliese R.
Gibbons, Kristen S.
Bertolone, Julia I.
Mahomed, Kassam
Title The medical management of missed miscarriage: outcomes from a prospective, single-centre, Australian cohort
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-729X
1326-5377
Publication date 2013-01-01
Sub-type Article (original research)
DOI 10.5694/mja12.11813
Open Access Status Not Open Access
Volume 199
Issue 5
Start page 341
End page 346
Total pages 6
Place of publication Strawberry Hills, NSW, Australia
Publisher Australasian Medical Publishing Company
Language eng
Subject 2700 Medicine
Formatted abstract
Objective: To report the prospective outcomes of medical management of missed miscarriage before 13 weeks' gestation from an Australian cohort.

Design: Descriptive study of a cohort selected out of a randomised controlled trial. Setting: Outpatient management at a maternity hospital between 1 May 2007 and 28 July 2010. Participants: 264 women requesting medical management of missed miscarriage.

Main outcome measures: Number of doses of misoprostol required, unscheduled visits for care, findings at ultrasound follow-up, requirement for surgical management, number of cases of gestational trophoblastic disease (GTD), and self-reported patient experience.

Results: 107 women (40.5%) received a repeat dose of misoprostol, and 79 women (29.9%) made unscheduled visits for care. Among the 241 women with Day 7 ultrasound follow-up, a gestational sac was found in 32 women (13.3%), indicating failure of medical management. Complete miscarriage was induced without the need for surgery in 206 women (78.0%). Surgery was performed as an emergency in 13 women (4.9%). Twelve women (4.5%) had surgery for ongoing bleeding after medical management, and four of these did not have chorionic villi on histopathological examination. Five women (1.9%) had GTD, which was managed incidentally under the protocol. Among those who returned patient questionnaires, 73.0% of participants (116/159) indicated that they would recommend medical management of miscarriage to other women, while 18.2% (29/159) indicated that they would undergo surgery next time.

Conclusion: The medical management of missed miscarriage on an outpatient basis is safe and effective.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
Non HERDC
School of Medicine Publications
 
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Created: Mon, 28 Apr 2014, 22:51:07 EST by Dominique Rossouw on behalf of Mater Research Institute-UQ