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Randomized Controlled Trial
. 2021 Sep;154(3):558-564.
doi: 10.1002/ijgo.13652. Epub 2021 Mar 24.

Misoprostol versus expectant management in women with incomplete first-trimester miscarriage after failed primary misoprostol treatment: A randomized clinical trial

Mohammed K Ali  1 , Samar M Emam  1 , Mahmoud A Abdel-Aleem  1 , Ahmed M A Sobh  1
Affiliations
Randomized Controlled Trial

Misoprostol versus expectant management in women with incomplete first-trimester miscarriage after failed primary misoprostol treatment: A randomized clinical trial

Mohammed K Ali et al. Int J Gynaecol Obstet. 2021 Sep.

Retraction in

  • Retraction.
    [No authors listed] [No authors listed] Int J Gynaecol Obstet. 2024 May;165(2):842. doi: 10.1002/ijgo.15450. Epub 2024 Feb 28. Int J Gynaecol Obstet. 2024. PMID: 38419152

Abstract

Objective: To compare the effectiveness and safety of repeat misoprostol versus expectant management in women with first-trimester incomplete miscarriage who have been initially treated with misoprostol.

Methods: The study was an open-labeled randomized controlled trial including women with an incomplete first-trimester miscarriage after administration of misoprostol. The participants were randomly assigned to vaginal misoprostol or expectant management using a computer-generated table of random numbers. The primary outcome was the number of women with a complete miscarriage at 1 week.

Results: Eighty-eight women (44 women in each group) were analyzed. The rate of complete miscarriage at 1 week was significantly higher in the misoprostol group than the expectant management group-29 (69.0%) versus 7 (16.7%) (P < 0.001), respectively. Women in the misoprostol group were more satisfied (7.00 ± 0.77 vs 4.57 ± 1.61, P < 0.001) but reported more pain (7.95 ± 1.85 vs 5.26 ± 1.08, P < 0.001) than women in the expectant group. The misoprostol group reported more adverse effects than the expectant management group (P < 0.001).

Conclusion: In women with an incomplete first-trimester miscarriage who were initially treated with misoprostol, repeat administration of misoprostol was more effective than expectant management for achieving complete miscarriage at 1 week. However, misoprostol was associated with more adverse effects.

Registration site and number: Clinicaltrials.gov: NCT03148561.

Keywords: incomplete miscarriage; misoprostol; prostaglandins; retained products of conception.

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