Effective treatment of miscarriage: A Synthesis of Findings from 32 Studies

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Original Abstract of the Article

Major Research Findings

A study published in 9 found that the method of managing early miscarriage (expectant management, medical management, or surgical management) does not affect subsequent pregnancy rates. About 80% of women who experienced a miscarriage gave birth within five years. The study concluded that women do not need to worry about long-term fertility concerns when making decisions about their miscarriage management.

In cases of incomplete evacuation of the uterus after misoprostol treatment for miscarriage, a study in 21 found that curettage leads to a higher chance of complete evacuation compared to expectant management. However, expectant management is successful in at least 76% of women. This finding suggests that curettage is a more effective option for complete evacuation, but expectant management is a safe and viable alternative that can avoid curettage for many women.

A study comparing micronized progesterone (MP) and dydrogesterone (DYD) for threatened miscarriage, published in , found no statistically significant differences in bleeding severity or subsequent miscarriage rates between the two treatment groups. However, fewer patients treated with DYD reported drowsiness and dizziness compared to MP. The finding of significantly higher miscarriage rates in women with low progesterone levels, regardless of treatment type, highlights the importance of considering progesterone levels when counseling and making predictions about pregnancy outcomes.

Treatment Summary

The study published in 9 showed that the method of managing early miscarriage (expectant management, medical management, or surgical management) does not affect subsequent pregnancy rates. The study published in 21 demonstrated that curettage is more effective for complete evacuation of the uterus after misoprostol treatment than expectant management, but expectant management is a safe and viable alternative. The study in found no significant differences in bleeding severity or miscarriage rates between micronized progesterone (MP) and dydrogesterone (DYD) treatment, but dydrogesterone was associated with fewer reports of drowsiness and dizziness.

Benefits and Risks

Benefit Summary

The method of managing early miscarriage does not affect subsequent pregnancy rates 9 .

Expectant management is a safe and viable option that can avoid curettage for many women 21 .

Risk Summary

Curettage is more effective for complete evacuation, but it can carry a higher risk of complications compared to expectant management 21 .

Dydrogesterone may be associated with fewer side effects, such as drowsiness and dizziness, compared to micronized progesterone .

Comparison Between Studies

Similarities

The studies agree that the method of managing early miscarriage does not affect subsequent pregnancy rates. They also concur that expectant management is a safe and viable alternative to curettage for many women.

Differences

The studies differ in their findings regarding the effectiveness of curettage compared to expectant management for complete evacuation of the uterus after misoprostol treatment. They also vary in their findings about the side effect profiles of different types of progesterone medications.

Consistency and Contradictions in Findings

The findings about the lack of impact of miscarriage management methods on subsequent pregnancy rates are consistent across studies. However, there are contradictions regarding the effectiveness of curettage versus expectant management for incomplete evacuation of the uterus. Additionally, further research is needed to fully understand the differences in side effect profiles of different progesterone medications.

Application to Real-Life Situations: Points to Consider

When choosing a method of managing early miscarriage, it is crucial to consider individual circumstances and preferences. Women should discuss their options with their healthcare provider and fully understand the risks and benefits of each approach. When using progesterone medications, it's important to be aware of the potential side effects.

Limitations of Current Research

Many studies on the long-term impact of miscarriage on pregnancy rates have a follow-up period of only five years. Longer-term follow-up studies are needed to fully understand the long-term impact of miscarriage. There are often concerns about the reliability of findings in studies comparing curettage and expectant management, as they tend to have smaller sample sizes. Furthermore, research comparing the side effect profiles of different progesterone medications may have limited generalizability due to the small range of medications and administration methods studied.

Future Research Directions

Future research should involve longer-term follow-up studies to assess the long-term impact of miscarriage on pregnancy rates. Larger, more robust studies are needed to compare curettage and expectant management for incomplete evacuation of the uterus. Additionally, future research should expand the range of progesterone medications and administration methods studied to enhance the generalizability of findings.

Conclusion

Numerous studies have shown that the method of managing early miscarriage does not affect subsequent pregnancy rates. However, further research is needed to determine the most effective approach for complete evacuation of the uterus after misoprostol treatment. It is important to remember that choosing a method of managing early miscarriage should be a collaborative decision between women and their healthcare providers, considering individual circumstances, preferences, and potential risks and benefits.

List of Treatments

Expectant Management, Medical Management (Misoprostol, Progesterone), Surgical Management (Curettage), Micronized Progesterone, Dydrogesterone

Literature analysis of 32 papers
Positive Content
29
Neutral Content
3
Negative Content
0
Article Type
15
15
14
13
32
1.

A randomised trial evaluating pain and bleeding after a first trimester miscarriage treated surgically or medically.

Author: JohnsonN, PriestnallM, MarsayT, BallardP, WattersJ

Reduced bleeding
Reduced pain
Reduced hemoglobin

Surgery for miscarriage was associated with less pain and bleeding compared to medical treatment, but resulted in a greater decrease in hemoglobin levels.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

[Spontaneous abortion. Drug treatment versus surgery].

Author: ClevinL, MunkT, HansenT R

Miscarriage management

Conservative treatment with prostaglandin E1 analogue or expectant management can substitute curettage in the management of spontaneous abortions with fresh vaginal bleeding and an endometrial thickness of up to 10 mm.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Danish

3.

Management of miscarriage: a randomized controlled trial of expectant management versus surgical evacuation.

Author: Wieringa-de WaardMargreet, VosJeroen, BonselGouke J, BindelsPatrick J E, AnkumWillem M

This study highlights the need for more randomized clinical trials to determine the best treatment for women experiencing a miscarriage, considering individual preferences for surgical uterine evacuation or expectant management.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Patient preferences for expectant management vs. surgical evacuation in first-trimester uncomplicated miscarriage.

Author: Wieringa-de WaardMargreet, BindelsPatrick J E, VosJeroen, BonselGouke J, StalmeierPeep F M, AnkumWillem M

Women who had previously experienced a miscarriage had strong treatment preferences for expectant or surgical management of future miscarriages.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Expectant care versus surgical treatment for miscarriage.

Author: NandaK, PeloggiaA, GrimesD, LopezL, NandaG

Improved miscarriage management
Miscarriage

Miscarriage is a common early pregnancy complication that can lead to both medical and emotional problems like depression and anxiety. Routine surgery to remove the pregnancy after a miscarriage is being questioned due to potential complications such as cervical damage, uterine perforation, bleeding, and infection.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Medical treatment for early fetal death (less than 24 weeks).

Author: NeilsonJ P, HickeyM, VazquezJ

Improved miscarriage management
Miscarriage

In many miscarriages, the baby stops developing weeks before the miscarriage occurs. Ultrasound can identify these issues, such as an empty sac or a non-viable baby. Historically, treatment before 14 weeks was surgical, but medical treatments and waiting for a natural miscarriage may be effective, safe, and acceptable options.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

7.

Progestogen for treating threatened miscarriage.

Author: WahabiH A, Abed AlthagafiN F, ElawadM

Improved threatened miscarriage treatment
Miscarriage

Miscarriage is a common problem during pregnancy. Progesterone is a hormone that plays a crucial role in preparing the uterus for a fertilized egg and maintaining pregnancy. Low progesterone levels in early pregnancy have been linked to miscarriage, and progesterone supplements have been used to treat threatened miscarriage and prevent loss of the pregnancy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

Treatment options and pregnancy outcome in women with idiopathic recurrent miscarriage: a randomized placebo-controlled study.

Author: FawzyMuhammad, ShokeirTarek, El-TatongyMohamed, WardaOsama, El-RefaieyAbdel-Aziz A, MosbahAlaa

Live births
Reduced miscarriage rates

Both enoxaparin and a combination therapy of prednisone, aspirin and progesterone were effective in improving pregnancy outcomes in women with idiopathic recurrent miscarriage.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

Incidence of pregnancy after expectant, medical, or surgical management of spontaneous first trimester miscarriage: long term follow-up of miscarriage treatment (MIST) randomised controlled trial.

Author: SmithLindsay F P, EwingsPaul D, QuinlanCatherine

Fertility preservation
Miscarriage management

Method of miscarriage management does not affect subsequent pregnancy rates, with around four in five women giving birth within five years of the index miscarriage.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Medical treatments for incomplete miscarriage (less than 24 weeks).

Author: NeilsonJames P, GyteGillian Ml, HickeyMartha, VazquezJuan C, DouLixia

Miscarriage treatment

Miscarriage occurs in 10-15% of pregnancies. The traditional treatment after a miscarriage has been surgery to remove any remaining pregnancy tissue. However, medications and a wait-and-see approach (expectant care) may be effective, safe, and acceptable alternatives.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

Progestogen for treating threatened miscarriage.

Author: WahabiHayfaa A, Abed AlthagafiNuha F, ElawadMamoun, Al ZeidanRasmieh A

Miscarriage treatment

Miscarriage is a common problem during pregnancy. Progesterone is a hormone that plays a crucial role in preparing the uterus for a fertilized egg and maintaining pregnancy. Low progesterone levels in early pregnancy have been linked to miscarriage, and progesterone supplements have been used to treat threatened miscarriage and prevent loss of the pregnancy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

12.

Progestogen for treating threatened miscarriage.

Author: WahabiHayfaa A, FayedAmel A, EsmaeilSamia A, Al ZeidanRasmieh A

Prevention of miscarriage

Miscarriage is a common problem during pregnancy. Progesterone is a hormone that plays a crucial role in preparing the uterus for a fertilized egg and maintaining pregnancy. Low progesterone levels in early pregnancy have been linked to miscarriage, and progesterone supplements have been used to treat threatened miscarriage and prevent loss of the pregnancy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

13.

Immediate versus delayed medical treatment for first-trimester miscarriage: a randomized trial.

Author: TorreAntoine, HuchonCyrille, BussieresLaurence, MachevinElise, CamusErick, FauconnierArnaud

Reduced surgical evacuation
Delayed treatment

Delayed medical treatment of first-trimester miscarriage increases the rate of unplanned surgical uterine evacuation.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

14.

Expectant care versus surgical treatment for miscarriage.

Author: NandaKavita, LopezLaureen M, GrimesDavid A, PeloggiaAlessandra, NandaGeeta

Miscarriage management
Cervical trauma
Hemorrhage
Infection
Uterine perforation

Miscarriage is a common experience that can lead to physical and emotional distress. While surgical removal of pregnancy tissue is a common practice after miscarriage, its routine use has been questioned due to potential complications like cervical injury, uterine perforation, bleeding, and infection.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

15.

Clinical and psychological impact after surgical, medical or expectant management of first-trimester miscarriage--a randomised controlled trial.

Author: KongGrace Wing Shan, LokIngrid Hung, YiuAlice Ka Wah, HuiAnnie Shuk Yi, LaiBeatrice Pui Yee, ChungTony Kwok Hung

Improved miscarriage outcomes
Post-traumatic stress

The study investigated the clinical and psychological outcomes of surgical, medical, and expectant management of first-trimester miscarriage. Surgical evacuation had the highest complete miscarriage rate, while expectant management resulted in fewer post-traumatic stress symptoms. Satisfaction was similar among all groups.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

16.

Medical treatments for incomplete miscarriage.

Author: NeilsonJames P, GyteGillian M L, HickeyMartha, VazquezJuan C, DouLixia

Miscarriage treatment

Miscarriage happens in about 10-15% of pregnancies. The traditional approach after a miscarriage has been to surgically remove any remaining pregnancy tissue (evacuation of uterus). However, medication or waiting for the body to naturally clear the tissue (expectant care) may also be effective, safe, and acceptable options.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

17.

Surgical versus expectant management in women with an incomplete evacuation of the uterus after treatment with misoprostol for miscarriage: the MisoREST trial.

Author: VerschoorMarianne A C, LemmersMarike, BossuytPatrick M, GraziosiGiuseppe C M, HajeniusPetra J, HendriksDave J, van HooffMarcel A H, van MeursHannah S, OpmeerBrent C, van TulderMaurits W, BouwmaLiesanne, CatshoekRuby, GeominiPeggy, KlinkertEllen R, LangenveldJosje, NieboerTheodoor E, van der PloegJ Marinus, RadderCeline M, SpinderTaeke, van der VoetLucy F, MolBen Willem J, HuirneJudith A F, AnkumWillem M

Miscarriage treatment
Incomplete evacuation

This study compares the effectiveness and cost-effectiveness of surgical management versus expectant management in women with incomplete miscarriage after misoprostol treatment. While misoprostol is a non-invasive option, incomplete evacuation is common, often leading to additional surgical intervention.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Unexplained Recurrent Miscarriage and Recurrent Implantation Failure: Is There a Place for Immunomodulation?

Author: MekinianArsène, CohenJonathan, Alijotas-ReigJaume, CarbillonLionel, Nicaise-RolandPascale, KayemGilles, DaraïEmile, FainOlivier, BornesMarie

Improved live birth rate
Treatment for recurrent miscarriages

This study examines the benefits of immunomodulatory drugs for recurrent miscarriages and implantation failures, finding evidence for the effectiveness of progesterone, TNF-α antagonists, G-CSF, and intralipids.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

A randomized double-blind controlled trial of the use of dydrogesterone in women with threatened miscarriage in the first trimester: study protocol for a randomized controlled trial.

Author: ChanDiana Man Ka, CheungKa Wang, YungSofie Shuk Fei, LeeVivian Chi Yan, LiRaymond Hang Wun, NgErnest Hung Yu

This research examined the evidence for using progestogens for treating threatened miscarriage. While progestogens are commonly used, the study concluded that current research is insufficient to support their routine use.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Low-Molecular-Weight Heparin for the Treatment of Unexplained Recurrent Miscarriage With Negative Antiphospholipid Antibodies: A Randomized Controlled Trial.

Author: ShaabanOmar M, AbbasAhmed M, ZahranKamal M, FathallaMohamed M, AnanMohamed A, SalmanSafwat A

RM treatment

This study aimed to evaluate the effect of low-molecular-weight heparin (LMWH) in the treatment of women with recurrent miscarriage (RM) who tested negative for antiphospholipid antibodies (APAs).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

21.

MisoREST: surgical versus expectant management in women with an incomplete evacuation of the uterus after misoprostol treatment for miscarriage: a randomized controlled trial.

Author: LemmersM, VerschoorM A C, Oude RengerinkK, NaaktgeborenC, OpmeerB C, BossuytP M, HuirneJ A F, JanssenC A H, RadderC, KlinkertE R, LangenveldJ, CatshoekR, Van der VoetL, SiemensF, GeominiP, Van HooffM H, Van der PloegJ M, CoppusS F P J, AnkumW M, MolB W J,

Complete evacuation of the uterus
Incomplete evacuation

Curettage is more effective than expectant management in women suspected of incomplete evacuation of the uterus after misoprostol treatment for first trimester miscarriage. However, expectant management is equally safe and prevents curettage for most of the women.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Does acupuncture have a role in the treatment of threatened miscarriage? Findings from a feasibility randomised trial and semi-structured participant interviews.

Author: BettsDebra, SmithCaroline A, DahlenHannah G

Threatened miscarriage treatment

This study investigated the feasibility of offering acupuncture as a treatment for women presenting with threatened miscarriage.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

23.

Supplementation with progestogens in the first trimester of pregnancy to prevent miscarriage in women with unexplained recurrent miscarriage: a systematic review and meta-analysis of randomized, controlled trials.

Author: SacconeGabriele, SchoenCorina, FranasiakJason M, ScottRichard T, BerghellaVincenzo

Higher live birth rate
Reduced miscarriage
Safe for fetuses
Difficult to recommend dosage

This systematic review and meta-analysis evaluated the efficacy of progestogens in reducing the incidence of miscarriage in women with a history of unexplained recurrent miscarriage. Progestogen supplementation in the first trimester was associated with a lower risk of recurrent miscarriage and a higher live birth rate. Further research is needed to optimize progestogen therapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

24.

Lymphocyte immunotherapy in the treatment of recurrent miscarriage: systematic review and meta-analysis.

Author: CavalcanteMarcelo Borges, SarnoManoel, Araujo JúniorEdward, Da Silva CostaFabricio, BariniRicardo

This research explores the use of immunotherapy in cases of recurrent miscarriage (RM). The study discusses the potential role of immunologic factors in RM and investigates the efficacy and safety of immunotherapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

25.

Medical treatments for incomplete miscarriage.

Author: KimCaron, BarnardSharmani, NeilsonJames P, HickeyMartha, VazquezJuan C, DouLixia

Miscarriage treatment

Miscarriage affects 10-15% of pregnancies. The traditional treatment has been to surgically remove any remaining placental tissue (evacuation of the uterus). However, medical treatments or simply waiting (expectant care) may also be effective, safe, and acceptable options.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

26.

The randomised controlled trial of micronised progesterone and dydrogesterone (TRoMaD) for threatened miscarriage.

Author: SiewJia Yun S, AllenJohn C, HuiCelene Y Y, KuChee Wai, MalhotraRahul, ØstbyeTruls, TanThiam Chye

Comparable outcomes for MP and DYD
Drowsiness with MP
Higher miscarriage risk with low progesterone

Micronized progesterone and dydrogesterone were equally effective in reducing vaginal bleeding and miscarriage rates in women presenting with threatened miscarriage. However, dydrogesterone was associated with fewer side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

27.

Progestogen for treating threatened miscarriage.

Author: WahabiHayfaa A, FayedAmel A, EsmaeilSamia A, BahkaliKhawater Hassan

Improved miscarriage treatment

This updated Cochrane Review investigated the evidence for progesterone supplementation in treating threatened miscarriage, considering its role in preventing spontaneous pregnancy loss.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

28.

Efficacy of progesterone on threatened miscarriage: Difference in drug types.

Author: WangXiao-Xue, LuoQing, BaiWen-Pei

miscarriage prevention
limited data

Progesterone agents were found to be effective in reducing the incidence of miscarriage in women who faced threatened miscarriage. The study found that dydrogesterone, but not natural progesterone, was associated with a lower risk of miscarriage.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

29.

Medical treatment for early fetal death (less than 24 weeks).

Author: LemmersMarike, VerschoorMarianne Ac, KimBobae Veronica, HickeyMartha, VazquezJuan C, MolBen Willem J, NeilsonJames P

Miscarriage treatment

Most miscarriages occur after the baby stops developing, often weeks before the miscarriage itself. Ultrasound can detect these issues early. While surgery has been the standard treatment, medications or simply waiting for a miscarriage to happen naturally may be equally effective, safe, and acceptable. This review updates previous research from 2006 on this topic.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

30.

Effect of progestogen for women with threatened miscarriage: a systematic review and meta-analysis.

Author: LiL, ZhangY, TanH, BaiY, FangF, FaramandA, ChongW, HaiY

Increased live birth
Reduced miscarriage

Progestogens, especially oral progestogen, may increase live birth rates and reduce miscarriage rates in women with threatened miscarriage.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

31.

Oral immunosuppressants improve pregnancy outcomes in women with idiopathic recurrent miscarriage: A meta-analysis.

Author: MaNana, QinRongyan, QinWeili, LiaoMing, ZhaoYunxiao, HangFu, QinAiping

Pregnancy outcome improvement
Infection

While immunotherapy is effective for idiopathic recurrent miscarriage (RM), oral immunosuppressants offer a less invasive and more convenient alternative. This study aims to analyze whether oral immunosuppressants can improve pregnancy outcomes in patients with idiopathic RM.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

32.

Medical management of early pregnancy loss is cost-effective compared with office uterine aspiration.

Author: NagendraDivyah, GutmanSarah M, KoelperNathanael C, Loza-AvalosSandra E, SonalkarSarita, SchreiberCourtney A, HarvieHeidi S

Treatment for early pregnancy loss

Early pregnancy loss is common, affecting approximately 1 million people in the United States annually. This study discussed different treatment options for early pregnancy loss, including expectant management, medications, and surgical procedures.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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