A randomized clinical trial comparing oral and vaginal misoprostol for medical evacuation of spontaneous abortion

Medical treatments for incomplete miscarriage (less than 24 weeks)

“…Fifteen studies involving 2750 women were included (Bique 2007; Blanchard 2004; Blohm 2005; Clevin 2001; Dao 2007; Moodliar 2005; Ngoc 2005; Niinimaki 2006; Pang 2001; Sahin 2001; Shelley 2005; Shwekerela 2007; Trinder 2006; Weeks 2005; Zhang 2005), a further four are awaiting classification (Diop 2009;Jabir 2009; Shaikh 2008; Yu 2000) and one is an ongoing trial (Unkels 2008). The remaining reports were excluded (reasons are given in table of Characteristics of excluded studies).…”

“…Twelve of the 15 included studies involved only women with incomplete miscarriage (Bique 2007; Blanchard 2004; Blohm 2005; Clevin 2001; Dao 2007; Moodliar 2005; Ngoc 2005; Pang 2001; Sahin 2001; Shelley 2005; Shwekerela 2007; Weeks 2005). Three studies included both women with incomplete miscarriage and women with an intrauterine fetal death (Niinimaki 2006; Trinder 2006; Zhang 2005).…”

“…Ten of the studies used ultrasound to confirm the diagnosis (Blanchard 2004; Blohm 2005; Clevin 2001; Dao 2007; Moodliar 2005; Ngoc 2005; Niinimaki 2006; Pang 2001; Shelley 2005; Zhang 2005). The other five studies used clinical assessment for the diagnosis (Bique 2007; Shelley 2005; Shwekerela 2007; Trinder 2006; Weeks 2005).…”

“…Blinding was adequate in only one study (Blohm 2005) and unclear in one study (Pang 2001), and for the remainder it was inadequate. However, for many studies it was considered not possible to blind, especially where medical treatment was being compared with surgery.…”

“…Loss to follow up and exclusions after randomisation were low in all studies except three. One where it was considered unclear (Clevin 2001) and two where it was considered high (Pang 2001; Weeks 2005). In the Pang study (Pang 2001) it appeared that intention-to-treat analysis was not used and the data could not be re-included.…”