A randomized study comparing efficacy and patient satisfaction in medical or surgical treatment of miscarriage

Objective: To compare the efficacy of the medical treatment to surgical uterine evacuation and patient satisfaction in each group. Design: A randomized controlled study. Setting: An outpatient clinic in the Department of Gynecology and Obsterics in Oulu University Hospital, Oulu, Finland. Patient(s): Ninety-eight eligible women who had miscarriages. Intervention(s): Medical treatment of miscarriage (n=49) with 200 mg of mifepristone and 0.8 mg of misoprostol 1-3 days after the event or surgical uterine evacuation (n=49). Questionnaires to collect data of experienced pain and patient satisfaction. Main Outcome Measure(s): The complete abortion rate with the primary treatment (primary outcome) and the patient satisfaction (secondary outcome). Result(s): The success rate was equal (100% in surgical and 90% in medical group). More infections were diagnosed in the surgical group. Surgically treated patients were more satisfied with the treatment (100% vs. 88%). Medical treatment was considered more painful and fewer patients (70% vs 91%) would choose the medical method in the future. Conclusion(s): Medical treatment is an effective alternative to surgical treatment and increase the choice available to women. Surgical treatment is associated with more infections. More medically treated patients experienced pain and dissatisfaction.