Table G.13How effective is expectant management of miscarriage compared with active treatment for improving women's clinical and psychological outcomes?

Bibliographic informationReason for exclusion
Bagratee,J.S., Khullar,V., Regan,L., Moodley,J., Kagoro,H., A randomized controlled trial comparing medical and expectant management of first trimester miscarriage, Human Reproduction, 19, 266-271, 2004Wrong comparator - placebo treatment is not the same as expectant management
Blohm,F., Friden,B.E., Milsom,I., Platz-Christensen,J.J., Nielsen,S., A randomised double blind trial comparing misoprostol or placebo in the management of early miscarriage, BJOG: An International Journal of Obstetrics and Gynaecology, 112, 1090-1095, 2005Wrong comparator - placebo treatment is not the same as expectant management
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
Butler,C., Kelsberg,G., St. Anna,L., How long is expectant management safe in first-trimester miscarriage?, Journal of Family Practice, 54, 889-890, 2005All relevant included RCTs have been included and analysed separately
Geyman,J.P., 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, 1999Review contains non RCTs. Two relevant included RCTs 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, 2004Relevant included studies have been included and analysed separately
Gronlund,L., Gronlund,A.L., Clevin,L., Andersen,B., Palmgren,N., Lidegaard,O., Spontaneous abortion: expectant management, medical treatment or surgical evacuation, Acta Obstetricia et Gynecologica Scandinavica, 81, 781-782, 2002Not a randomised controlled trial
Mahmood,T.A., Shehata,K.I., Thong,K.J., A randomized study of conservative management versus surgical uterine evacuation for incomplete miscarriage (interim analysis), International Journal of Gynecology and Obstetrics, 70, 68-69, 2000Abstract only
McCreight,B.S., Perinatal loss: a qualitative study in Northern Ireland, Omega: Journal of Death and Dying, 57, 1-19, 2008Wrong population - included women with late pregnancy loss. No relevant outcomes reported.
Nanda,K., Peloggia,A., Grimes,D.A., Lopez,L. M., Nanda,G., Expectant care versus surgical treatment for miscarriage, Cochrane Database of Systematic Reviews, -, 2009All included studies relevant to this review question were appraised for inclusion individually
Nanda,K., Peloggia,A., Grimes,D. A., Lopez,L.M., Nanda,G., Expectant care versus surgical treatment for miscarriage, Cochrane Database of Systematic Reviews, -, 2010All included studies relevant to this review question have been included and analysed separately (except one in German and one reported as an abstract 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-, 2010Abstract only
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-, 2006Only one relevant included study, which has been included and analysed separately
Nielsen,S., Hahlin,M., Expectant management of first-trimester miscarriage, Problems in early pregnancy - advances in diagnosis and management, 265-276p. 1997., -276p, NoneBook chapter reporting data from trials already included in the review
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 - only included women undergoing surgical management
Pauleta,J.R., Clode,N., Graca,L.M., Expectant management of incomplete abortion in the first trimester, International Journal of Gynaecology and Obstetrics, 106, 35-38, 2009Observational study
Petrou,S., McIntosh,E., Women's preferences for attributes of first-trimester miscarriage management: a stated preference discrete-choice experiment, Value in Health, 12, 551-559, 2009Predictive model for health economic analysis. The same population is also reported in another qualitative paper included in this review (Smith 2006)
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, 2005Any relevant included studies have been included and analysed separately
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, 2002Wrong population - women who were managed “expectantly” were already diagnosed with a complete miscarriage when the study started and were not randomised.
Thong,K.J., Mahmood,T.A., A randomised study of conservative management versus evacuation of the uterus for first trimester miscarriage, Health Bulletin, 55, 277, 1997-, 1997Abstract only
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
Wieringa-de Waard, M., Ankum,W.M., Bonsel,G.J., Vos,J., Biewenga,P., Bindels,P.J., The natural course of spontaneous miscarriage: analysis of signs and symptoms in 188 expectantly managed women, British Journal of General Practice, 53, 704-708, 2003Subgroup analysis of one arm of an RCT already included. No reported outcomes of interest.
Wieringa-de Waard, M., Bindels,P.J., Vos,J., Bonsel,G.J., Stalmeier,P.F., Ankum,W.M., Patient preferences for expectant management vs. surgical evacuation in first-trimester uncomplicated miscarriage, Journal of Clinical Epidemiology, 57, 167-173, 2004Very low response rate (57%), with poor reporting of outcomes.
Wijesinghe,P.S., Padumadasa,G.S., Palihawadana,T.S., Marleen,F.S., A trial of expectant management in incomplete miscarriage, Ceylon Medical Journal, 56, 10-13, 2011Study was not conducted in a developed country

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.

No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK [www.cla.co.uk]. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.