Table G.14How effective is surgical management of miscarriage compared with medical management for improving women's clinical and psychological outcomes?

Bibliographic informationReason for exclusion
Ankum,W.M., Wieringa-de Waard, M., Bindels,P.J., Management of spontaneous miscarriage in the first trimester: an example of putting informed shared decision making into practice. [26 refs], BMJ, 322, 1343-1346, 2001The included studies in this review have been included and analysed separately.
Bique,C., Usta, M., Debora,B., Chong,E., Westheimer,E., Winikoff,B., Comparison of misoprostol and manual vacuum aspiration for the treatment of incomplete abortion, International Journal of Gynaecology and Obstetrics, 98, 222-226, 2007Incorrect population - self-reported induced abortion rate of 49-50% in current pregnancy
Bui,Q., Management options for early incomplete miscarriage, American Family Physician, 83, 258-260, 2011Summary of a Cochrane review that has already been appraised for inclusion in full text
Chung,T.K.H., Cheung,L.P., Haines,C.J., Spontaneous abortion: A randomized controlled trial of misoprostol versus routine surgical evacuation, Acta Obstetricia et Gynecologica Scandinavica, 76, 72, 1997-, 1997This trial is reported in more detail in another included paper (Chung et al. 1999).
Chung,T.K.H., Cheung,L.P., Lee,D.T.S., Haines,C.J., Spontaneous abortion: a randomized controlled trial of misoprostol versus routine uterine curettage, British Journal of Obstetrics and Gynaecology, Vol.105 Suppl 17, pp.127, 1998., -, -32676This trial is reported in more detail in another included paper (Chung et al. 1999).
Clevin,L., Munk,T., Hansen,T.R., Spontaneous abortion, medical versus surgical management, Ugeskrift for laeger, 163, 2136-2139, 2001The paper is in Danish, with insufficient detail reported in the English abstract.
Erratum: Medical management of missed abortion: A randomized clinical trial (Obstetrics and Gynecology (2002) 99 (563-566)), Obstetrics and Gynecology, 100, 175-, 2002Erratum is not relevant to any included paper.
Geyman,J.P., Oliver,L.M., Sullivan,S.D., Expectant, medical, or surgical treatment of spontaneous abortion in first trimester of pregnancy? A pooled quantitative literature evaluation, Journal of the American Board of Family Practice, 12, 55-64, 1999The included studies in this review have been included and analysed separately.
Graziosi,G.C.M., Mol,B.W., Ankum,W.M., Bruinse,H.W., Management of early pregnancy loss, International Journal of Gynecology and Obstetrics, 86, 337-346, 2004The included studies in this review have been included and analysed separately.
Hausler,M.C.H., Koroschetz,F., Tamussino,K., Walcher,W., Complete first trimester spontaneous abortion managed with or without curretage - A prospective, randomised trial. <Original> Ist eine curettage nach abortus completus noch zeitgemass? Eine prospektiv randomisierte studie, Geburtshilfe Und Frauenheilkunde, 57, 396-399, 1997The paper is in German, with insufficient detail reported in the English abstract.
Hinshaw,K., Rispin,R., Smith,N., Templeton,A., Medical vs surgical management in first trimester miscarriage: a prospective, pragmatic random allocation trial, Journal of Obstetrics and Gynaecology, 13, 404-405, 1993Preliminary summary of another included trial (Hinshaw, H.K.S. 1997) that reports no additional relevant outcomes.
Hughes,J., Ryan,M., Hinshaw,K., Henshaw,R., Rispin,R., Templeton,A., The costs of treating miscarriage: a comparison of medical and surgical management, British Journal of Obstetrics and Gynaecology, 103, 1217-1221, 1996Outcomes are not reported separately for randomised and non-randomised women
Johnson,N., Priestnall,M., Marsay,T., Ballard,P., Watters,J., A randomised trial evaluating pain and bleeding after a first trimester miscarriage treated surgically or medically, European Journal of Obstetrics, Gynecology, and Reproductive Biology, 72, 213-215, 1997Incorrect population - participants include an unreported number of women with complete miscarriages
Murphy,F.A., Lipp,A., Powles,D.L., Follow-up for improving psychological well being for women after a miscarriage, Cochrane Database of Systematic Reviews, -, 2010No outcomes reported (protocol only)
Neilson,J.P., Gyte,G.M., Hickey,M., Vazquez,J.C., Dou,L., Medical treatments for incomplete miscarriage (less than 24 weeks). [187 refs], Cochrane Database of Systematic Reviews, CD007223-, 2010The included studies in this review have been included and analysed separately.
Neilson,J.P., Hickey,M., Vazquez,J., Medical treatment for early fetal death (less than 24 weeks). [102 refs], Cochrane Database of Systematic Reviews, 3, CD002253-, 2006The included studies in this review have been included and analysed separately.
Neilson,J.P., Hickey,M., Vazquez,J.C., Medical treatment for early fetal death (less than 24 weeks), Cochrane Database of Systematic Reviews, -, 2009The included studies in this review have been included and analysed separately.
Paraskevaides,E., Prendiville,W., Stuart,B., Scanaill,S.N., Walsh,D., McGuinness,N., Afrasiabi,M., Daly,S., Medical evacuation of first trimester (twelve weeks gestation) incomplete abortion and missed abortion, Journal of Gynecologic Surgery, 8, 159-163, 1992No outcomes of interest reported for both medical and surgical groups.
Paton,F., Wood,R., Grief in miscarriage patients and satisfaction with care in a London hospital, Journal of Reproductive and Infant Psychology, 17, 301-301, 1999Non-comparative study - examines surgical management only, with no comparison to medical management.
Scott,L., Medical management in the community as an option for first trimester miscarriage, Nursing Times, 106, 17-19, 2010Does not report a comparison of surgical and medical management
Shaikh,Z.A.N., Comparison between misoprostol alone and misoprostol with manual vacuum aspiration for the treatment of missed and incomplete miscarriage, BJOG: an international journal of obstetrics and gynaecology, 115, 83, 2008-, 2008Poster abstract with insufficient detail reported.
Sotiriadis,A., Makrydimas,G., Papatheodorou,S., Ioannidis,J.P., Expectant, medical, or surgical management of first-trimester miscarriage: a meta-analysis. [42 refs], Obstetrics and Gynecology, 105, 1104-1113, 2005The included studies in this review have been included and analysed separately, with the exception of one non-randomised trial.
Tam,W.H., Lau,W.C., Cheung,L.P., Yuen,P.M., Chung,T.K., Intrauterine adhesions after conservative and surgical management of spontaneous abortion, Journal of the American Association of Gynecologic Laparoscopists, 9, 182-185, 2002No outcomes of interest reported
Wallace,R.R., Goodman,S., Freedman,L.R., Dalton,V.K., Harris,L.H., Counseling women with early pregnancy failure: Utilizing evidence, preserving preference, Patient education and counseling, 81, 454-461, 2010Non-systematic review
Weeks,A., Alia,G., Blum,J., Winikoff,B., Ekwaru,P., Durocher,J., Mirembe,F., A randomized trial of misoprostol compared with manual vacuum aspiration for incomplete abortion, Obstetrics and Gynecology, 106, 540-547, 2005Incomplete reporting of outcomes - loss to follow-up was 39% for the primary outcome of treatment success, and all other outcomes reported at follow-up.
Zalanyi,S., Vaginal misoprostol alone is effective in the treatment of missed abortion, British Journal of Obstetrics and Gynaecology, 105, 1026-1028, 1998Incorrect study design - not a randomised controlled trial
Zhang,J., Gilles,J., Barnhart,K., Creinin,M., Westhoff,C., Frederick,M.M., Medical management with misoprostol for early pregnancy failure: a multicenter, randomized equivalence trial [abstract], Fertility and Sterility, Vol.82 Suppl 2, pp.S53-S54, 2004., - S54, 2004This trial is reported in more detail in another included paper (Zhang et al. 2005).

From: Appendix G, Excluded studies

Cover of Ectopic Pregnancy and Miscarriage
Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management in Early Pregnancy of Ectopic Pregnancy and Miscarriage.
NICE Clinical Guidelines, No. 154.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG; 2012 Dec.
Copyright © 2012, National Collaborating Centre for Women's and Children's Health.

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