ReviewDeutsches Arzteblatt international2021
Treatment Options After a Diagnosis of Early Miscarriage: Expectant, Medical, and Surgical.
Review in Deutsches Arzteblatt international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 22 citations in OpenAlex.
- Childbearing and Pregnancy Trends Among Female Plastic and Orthopedic/Trauma Surgeons in German-speaking Countries.Plastic and reconstructive surgery. Global open · 2025Article
- Early Pregnancy Loss in the 1st Trimester: Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/076; August 2024).Geburtshilfe und Frauenheilkunde · 2025Article
- Cell-Free DNA Analysis of Fetal Aneuploidies in Early Pregnancy Loss.Journal of clinical medicine · 2024Article
- Assisted reproduction after SARS-CoV-2-infection: results of a single-center cohort-study.Archives of gynecology and obstetrics · 2024Article
- Epidemiology of spontaneous pregnancy loss in Kazakhstan: A national population-based cohort analysis during 2014-2019 using the national electronic healthcare system.Acta obstetricia et gynecologica Scandinavica · 2023Article
- Article
- Hemostasis System and Plasminogen Activity in Retrochorial Hematoma in the First Trimester of Pregnancy.Biomedicines · 2022Article
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Authors and funding
4 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundApproximately 12% of pregnancies end in an early miscarriage (up to week 12 + 0 of pregnancy). Over the past 10 to 15 years, two alternatives to curettage have appeared in the pertinent international treatment guidelines: expectant treatment and medical (drug) treatment. In this review, we discuss the advantages and disadvantages of each of these therapeutic options.
methodsThis review is based on pertinent publications (January 2000 to February 2021) retrieved by a selective search in PubMed, as well as on the guidelines of the American College of Obstetrics and Gynecologists, the Association of the Scientific Medical Societies in Germany, the National Institute for Health and Care Excellence/Royal College of Obstetricians and Gynaecologists, and the International Federation of Gynaecology and Obstetrics.
resultsThree effective and safe treatment options are available after a diagnosis of early miscarriage. Expectant treatment yields success rates of 66-91%, depending on the type of miscarriage. Its complications include hemorrhage requiring blood transfusion in 1-2% of cases. If expectant therapy fails, subsequent treatment with misoprostol or curettage is indicated. Drug therapy with misoprostol yields a complete termination in 81-95% of cases and is thus a valid alternative to expectant therapy, with the advantage of better planning capability. The vaginal application of misoprostol is the most effective means of administration, with the fewest side effects. Curettage is needed in 5-20% of cases. Suctional curettage has a success rate of 97-98%, with an associated anesthesia-related risk of 0.2%, a 0.1% risk of perforation, and a 2-3% rate of repeat curettage.
conclusionIf there is no acute indication for the surgical treatment of an early miscarriage, the patient can choose among three treatment options. Expectant and medical treatment can be provided on an outpatient basis. Curettage is the treatment of choice in the presence of infection, marked and persistent bleeding, hemodynamic instability, or a pre-existing coagulopathy.
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