ArticlePloS one2019
Medical versus surgical treatment of first trimester spontaneous abortion: A cost-minimization analysis.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 16 papers.
What it found
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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.
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Who cites it
16 citing papers in PubMed, 36 citations in OpenAlex.
- Medical management of early pregnancy loss is cost-effective compared with office uterine aspiration.American journal of obstetrics and gynecology · 2022Trial
- Comparative efficacy and safety of medical and surgical management for missed miscarriage: a systematic review and meta-analysis.Frontiers in medicine · 2026Review
- Clinical Effectiveness and Cost-Effectiveness of Misoprostol in Comparison to Dilatation and Curettage for Treatment of First-Trimester Missed Abortion (Gestational Age ≤ 14 Weeks) in Iran.Health science reports · 2025Article
- The chromosomal characteristics of spontaneous abortion and its potential associated copy number variants and genes.Journal of assisted reproduction and genetics · 2024Article
- Effect of oral mifepristone and vaginal misoprostol for early abortion among Indian women.Bioinformation · 2024Article
- Navigating miscarriage in Jordan: understanding emotional responses and coping strategies.BMC pregnancy and childbirth · 2023Article
- Women's perceptions of and experiences with the use of misoprostol for treatment of incomplete abortion in central Malawi: a mixed methods study.Reproductive health · 2023Article
- Comparison of the clinical efficacy of surgical versus medical method for first trimester pregnancy termination in Iran: A quasi-experimental research.Journal of education and health promotion · 2023Article
- Experiences of Using Misoprostol in the Management of Incomplete Abortions: A Voice of Healthcare Workers in Central Malawi.International journal of environmental research and public health · 2022Article
- Cost Analysis of Surgical and Medical Uterine Evacuation Methods for First-Trimester Abortion Used in Public Hospitals in Mexico.Health services insights · 2022Article
- Economic evaluation of medical versus surgical strategies for first trimester therapeutic abortion: A systematic review.Journal of education and health promotion · 2022Review
- Comparative clinical genetic testing in spontaneous miscarriage: Insights from a study in Southern Chinese women.Journal of cellular and molecular medicine · 2021Article
- Evaluating the agreement of ultrasound imaging and beta-human chorionic gonadotropin (β-hCG) measurement in confirming completed medical abortion: cross-sectional study.Qatar medical journal · 2021Article
- First trimester miscarriage: patient care considerations for the dental team.British dental journal · 2020Article
- A prospective observational study of the follow-up of medical management of early pregnancy failure.Journal of family medicine and primary care · 2019Article
- Correction: Medical versus surgical treatment of first trimester spontaneous abortion: A cost-minimization analysis.PloS one · 2019Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTraditionally the gold-standard technique for the treatment of spontaneous abortion has been uterine evacuation by aspiration curettage. However, many studies have proposed medical treatment with misoprostol as an alternative to the conventional surgical treatment. The aim of this study was to apply cost minimization methods to compare the cost and effectiveness of the use of vaginal misoprostol as a medical treatment for first trimester spontaneous abortion with those of evacuation curettage as a surgical treatment. METHODOLOGY/PRINCIPAL
findingsWe present a longitudinal, prospective and quasi-experimental research study including a total of 547 patients diagnosed with first-trimester spontaneous abortion, in the period from January 2013 to December 2015. Patients were offered medical treatment with 800 mg vaginal misoprostol or evacuation curettage. Patients treated with misoprostol were followed-up at 7 days and a transvaginal ultrasound was performed to confirm the success of the treatment. If it failed, a second dose of 800 mg of vaginal misoprostol was prescribed and a new control ultrasound was performed. In case of failure of medical treatment after the second dose of misoprostol, evacuation curettage was indicated. The effectiveness of each of the treatment options was calculated using a decision tree. The cost minimization study was carried out by weighting each cost according to the effectiveness of each branch of the treatment. Of the 547 patients who participated in the study, 348 (64%) chose medical treatment and 199 (36%) chose surgical treatment. The overall effectiveness of medical treatment was 81% (283/348) and surgical treatment of 100%. The estimated final cost for medical treatment was € 461.92 compared to € 2038.72 for surgical treatment, which represents an estimated average saving per patient of € 1576.8. CONCLUSIONS/SIGNIFICANCE: Medical treatment with misoprostol is a cheaper alternative to surgery: in the Spanish Public Healthcare System, it is five times more inexpensive than curettage. Given its success rates higher than 80%, mild side effects, controllable with additional medication and the high degree of overall satisfaction, it should be prioritized over the evacuation curettage in patients who meet the treatment criteria.
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