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.