AbbreviationsCEA curvescost‐effectiveness acceptability curvesICERincremental cost‐effectiveness ratioNHSNational Health ServiceQALYquality adjusted life yearSF‐36Short Form‐36Key MessageIn women with an incomplete evacuation of the uterus after misoprostol treatment for first‐trimester miscarriage, curettage is not cost‐effective over expectant management. Therefore, the use of curettage for this indication should be restrained.IntroductionAround 10–15% of all clinically recognized pregnancies end in a miscarriage . In the last decade, misoprostol was introduced as a treatment option for first‐trimester miscarriages alongside expectant management and curettage . Misoprostol is an effective treatment for 50–85% of women who have a miscarriage. In the remaining women, ultrasound scanning during follow up shows incomplete evacuation of the uterus . Generally, this finding leads to additional curettage, despite most women being relatively asymptomatic. Medical treatment with misoprostol for miscarriage was found to be cost‐effective in comparison with curettage in several studies , although this result was not confirmed by others .The MisoREST trial was a randomized controlled trial that compared curettage and expectant management in women with incomplete evacuation of the uterus after misoprostol treatment for first‐trimester miscarriage . In this trial, significantly more women had an empty uterus after curettage than after expectant management (96% vs. 83%, relative risk 1.15, 95% confidence interval
Acta Obstetricia Et Gynecologica Scandinavica – Wiley
Published: Jan 1, 2018
Keywords: ; ; ; ;
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