Impact of Spontaneous Abortion of First-Trimester on Medical Management: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials

Abstract

Medical management is a relatively safer option than the conventional surgical method in the first-trimester miscarriage. The chapter included studies which allocated women in the pharmacological intervention for spontaneous miscarriage in the first trimester and determined the effectiveness, safety, and side-effect. Authors have included study trials of women with first-trimester miscarriage and conducted a review generating both direct and mixed evidence on the effectiveness and side effects of medical management. Out of 2246 studies found in the databases, 32 were included in the systematic review comprising of 56116 patients undergoing first-trimester miscarriage with 54,890 undergoing medical termination of pregnancy, and 7 studies were included in the meta-analysis. Results showed that the odds of success in medical intervention were low when compared with surgical intervention. Medical management of patients with symptoms of early miscarriage is safer and more effective compared to expectant and well tolerated compared to surgical management.