Cost‐effectiveness of curettage vs. expectant management in women with an incomplete evacuation after misoprostol treatment for first‐trimester miscarriage: a randomized controlled trial and cohort study

Cost‐effectiveness of curettage vs. expectant management in women with an incomplete evacuation... 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 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acta Obstetricia Et Gynecologica Scandinavica Wiley

Cost‐effectiveness of curettage vs. expectant management in women with an incomplete evacuation after misoprostol treatment for first‐trimester miscarriage: a randomized controlled trial and cohort study

Loading next page...
 
/lp/wiley/cost-effectiveness-of-curettage-vs-expectant-management-in-women-with-6V5wh8Dvf8
Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
Copyright © 2018 Acta Obstetricia et Gynecologica Scandinavica
ISSN
0001-6349
eISSN
1600-0412
D.O.I.
10.1111/aogs.13283
Publisher site
See Article on Publisher Site

Abstract

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

Journal

Acta Obstetricia Et Gynecologica ScandinavicaWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create lists to
organize your research

Export lists, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off