Trial reportBMJ (Clinical research ed.)2006
Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial).
Trial report in BMJ (Clinical research ed.), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 72 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Treatment of Early Pregnancy Failure
Expectant Management Versus Medical Management of Retained Products of Conception After Induced Abortion
Who cites it
72 citing papers in PubMed, 10 syntheses or guidelines pooled it, 296 citations in OpenAlex.
- Prophylactic antibiotics for uterine evacuation procedures to manage miscarriage.The Cochrane database of systematic reviews · 2025Pooled it
- Predictors of successful expectant and medical management of miscarriage: A systematic review.Acta obstetricia et gynecologica Scandinavica · 2024Pooled it
- Methods for managing miscarriage: a network meta-analysis.The Cochrane database of systematic reviews · 2021Pooled it
- Medical treatment for early fetal death (less than 24 weeks).The Cochrane database of systematic reviews · 2019Pooled it
- Medical treatments for incomplete miscarriage.The Cochrane database of systematic reviews · 2017Pooled it
- Antibiotics for treating septic abortion.The Cochrane database of systematic reviews · 2016Pooled it
- Follow-up for improving psychological well being for women after a miscarriage.The Cochrane database of systematic reviews · 2012Pooled it
- Expectant care versus surgical treatment for miscarriage.The Cochrane database of systematic reviews · 2012Pooled it
- Medical treatments for incomplete miscarriage (less than 24 weeks).The Cochrane database of systematic reviews · 2010Pooled it
- Medical treatment for early fetal death (less than 24 weeks).The Cochrane database of systematic reviews · 2006Pooled it
- Hysteroscopic management versus ultrasound-guided evacuation for women with first-trimester pregnancy loss, a randomised controlled trial.BMC women's health · 2022Trial
- Timing and efficacy of mifepristone pretreatment for medical management of early pregnancy loss.Contraception · 2021Trial
- First-trimester fetal growth restriction and the occurrence of miscarriage in rural Bangladesh: A prospective cohort study.PloS one · 2017Trial
- Trial
- Surgical versus expectant management in women with an incomplete evacuation of the uterus after treatment with misoprostol for miscarriage: the MisoREST trial.BMC pregnancy and childbirth · 2013Trial
- A cost-effectiveness analysis of surgical versus medical management of early pregnancy loss.Fertility and sterility · 2012Trial
- Incidence of pregnancy after expectant, medical, or surgical management of spontaneous first trimester miscarriage: long term follow-up of miscarriage treatment (MIST) randomised controlled trial.BMJ (Clinical research ed.) · 2009Trial
- Quality of life and acceptability of medical versus surgical management of early pregnancy failure.BJOG : an international journal of obstetrics and gynaecology · 2008Trial
- Management of Early Pregnancy Loss: Reproductive Outcome in Subsequent Euploid Embryo Transfers.Reproductive sciences (Thousand Oaks, Calif.) · 2026Article
- Outcomes from blind versus ultrasound-guided uterine evacuation: A retrospective cohort analysis.Acta obstetricia et gynecologica Scandinavica · 2026Article
12 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo ascertain whether a clinically important difference exists in the incidence of gynaecological infection between surgical management and expectant or medical management of miscarriage.
designRandomised controlled trial comparing medical and expectant management with surgical management of first trimester miscarriage.
settingEarly pregnancy assessment units of seven hospitals in the United Kingdom.
participantsWomen of less than 13 weeks' gestation, with a diagnosis of early fetal demise or incomplete miscarriage.
interventionsExpectant management (no specific intervention); medical management (vaginal dose of misoprostol preceded, for women with early fetal demise, by oral mifepristone 24-48 hours earlier); surgical management (surgical evacuation).
main outcome measuresConfirmed gynaecological infection at 14 days and eight weeks; need for unplanned admission or surgical intervention.
results1200 women were recruited: 399 to expectant management, 398 to medical management, and 403 to surgical management. No differences were found in the incidence of confirmed infection within 14 days between the expectant group (3%) and the surgical group (3%) (risk difference 0.2%, 95% confidence interval - 2.2% to 2.7%) or between the medical group (2%) and the surgical group (0.7%, - 1.6% to 3.1%). Compared with the surgical group, the number of unplanned hospital admissions was significantly higher in both the expectant group (risk difference - 41%, - 47% to - 36%) and the medical group (- 10%, - 15% to - 6%). Similarly, when compared with the surgical group, the number of women who had an unplanned surgical curettage was significantly higher in the expectant group (risk difference - 39%, - 44% to - 34%) and the medical group (- 30%, - 35% to - 25%).
conclusionsThe incidence of gynaecological infection after surgical, expectant, and medical management of first trimester miscarriage is low (2-3%), and no evidence exists of a difference by the method of management. However, significantly more unplanned admissions and unplanned surgical curettage occurred after expectant management and medical management than after surgical management. TRIAL REGISTRATION NATIONAL RESEARCH REGISTER: N0467011677/N0467073587.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.