Graziosi G C M, Mol B W, Ankum W M, Bruinse H W
Department of Obstetrics and Gynecology, St. Antonius Hospital, Nieuwegein, The Netherlands.
Int J Gynaecol Obstet. 2004 Sep;86(3):337-46. doi: 10.1016/j.ijgo.2004.04.038.
In order to assess the available evidence on the management of early pregnancy loss, we performed a meta-analysis on the subject.
MEDLINE and EMBASE were searched for randomized studies reporting on the effectiveness of expectant management, misoprostol treatment or curettage. Outcomes considered were 'complete evacuation', complications, duration of bleeding, pain resulting from the procedure, side effects and women's satisfaction with the procedure.
Thirteen studies were identified. Combined data in women with missed abortion managed expectantly or treated with misoprostol showed complete evacuation rates of 28% (49/173) (range 14-47%) and 81% (242/298) (range 60-83%), respectively. In women with incomplete abortion, these rates were 94% (31/33) (range 80-100%) and 99% (75/76) (range 99-100%), respectively.
In the management of early pregnancy loss both expectant management and misoprostol treatment reduce the need for curettage, but misoprostol treatment seems to be more effective in women with missed abortion as compared to expectant management.
为了评估早期流产管理方面的现有证据，我们对该主题进行了一项荟萃分析。
检索MEDLINE和EMBASE数据库，查找关于期待疗法、米索前列醇治疗或刮宫术有效性的随机研究。所考虑的结局包括“完全排空”、并发症、出血持续时间、手术引起的疼痛、副作用以及女性对手术的满意度。
共纳入13项研究。对稽留流产女性进行期待治疗或米索前列醇治疗的综合数据显示，完全排空率分别为28%（49/173）（范围14 - 47%）和81%（242/298）（范围60 - 83%）。对于不全流产女性，这些比率分别为94%（31/33）（范围80 - 100%）和99%（75/76）（范围99 - 100%）。
在早期流产的管理中，期待疗法和米索前列醇治疗均减少了刮宫的必要性，但与期待疗法相比，米索前列醇治疗在稽留流产女性中似乎更有效。
