Bleeding patterns after misoprostol vs surgical treatment of early pregnancy failure: results from a randomized trial - 22/08/11
, Sarah K. Hendlish, MPH 1, Carolyn Westhoff, MD 1, Margaret M. Frederick, PhD, MD 2, Jun Zhang, PhD, MD 3, Jerry M. Gilles, MD 4, Kurt Barnhart, MD, MSCE 5, Mitchell D. Creinin, MD 6National Institute of Child Health and Human Development Management of Early Pregnancy Failure Trial
Reprint requests: Anne R. Davis, MD, Columbia University, Department of Obstetrics & Gynecology, 622 West 168th St, PH 16 Room 80, New York, NY 10032Résumé |
Objective |
The purpose of this study was to describe bleeding patterns after misoprostol or curettage for early pregnancy failure (EPF).
Study design |
This was a randomized trial that included women (n = 652) with EPF. Participants were assigned to vaginal misoprostol (800 μg) or curettage in a 3:1 ratio. Participants completed a bleeding diary. We measured hemoglobin levels at baseline and 2 weeks after the treatment.
Results |
Decreases in hemoglobin levels were greater after misoprostol (−0.7 g/dL; SD, 1.2) than curettage (−0.2 g/dL; SD, 0.9; P < .001). Large changes in hemoglobin levels (at least 2 g/dL) or low nadir hemoglobin levels (< 10 g/dL) were more frequent after misoprostol (55/428 women; 12.8%) than after curettage (6/135 women; 4.4%; P = .02). More participants in the misoprostol group reported “any bleeding” or “heavy bleeding” every study day. Four women who were treated with misoprostol required blood transfusion.
Conclusion |
Bleeding is heavier and more prolonged after medical treatment with misoprostol than with curettage for EPF; however, bleeding rarely requires intervention.
Le texte complet de cet article est disponible en PDF.Key words : early pregnancy failure, miscarriage, misoprostol, curettage
Plan
| Funded by contracts (N01-HD-1-3321, N01-HD-3322, N01-HD-3323, N01-HD-3324, and N01-HD-3325) with the National Institute of Child Health and Human Development, National Institutes of Health. Cite this article as: Davis AR, Hendlish SK, Westhoff C, et al. Bleeding patterns after misoprostol vs surgical treatment of early pregnancy failure: results from a randomized trial. Am J Obstet Gynecol 2007;196:31.e1-31.e7. |
Vol 196 - N° 1
P. null - janvier 2007 Retour au numéro
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