Natural approach not always best with miscarriage

Study suggests medical management is as effective as surgical options

Letting nature take its course may not be the best option for women experiencing a first trimester miscarriage, with data from more than 9000 women suggesting medical treatment may be a better first-line treatment option.

Expectant management was 24% less likely to result in complete expulsion of the products of conception compared with treatment with misoprostol, according to what is believed to be the first meta-analysis of all current treatment options for miscarriage between 0 and 14 weeks.

But misoprostol was as effective as the surgical options — sharp dilation and curettage, electric vacuum aspiration and manual vacuum aspiration — for achieving complete expulsion, the University of Warwick and Queen Mary University of London researchers reported in Human Reproduction Update.

Side effects were similar for misoprostol-based treatment and surgical options, they wrote.

The results support

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