Medical treatment of second-trimester fetal miscarriage; A retrospective analysis.
Research on the treatment of second-trimester miscarriages is scarce. We studied the outcomes, and the factors associated with adverse events and need for hospital resources in the medical treatment of second-trimester miscarriage.In these retrospective analyses we studied women treated for spontane...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2017-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5533459?pdf=render |
| _version_ | 1828842167872782336 |
|---|---|
| author | Maarit Niinimäki Maarit Mentula Reetta Jahangiri Jaana Männistö Annina Haverinen Oskari Heikinheimo |
| author_facet | Maarit Niinimäki Maarit Mentula Reetta Jahangiri Jaana Männistö Annina Haverinen Oskari Heikinheimo |
| author_sort | Maarit Niinimäki |
| collection | DOAJ |
| description | Research on the treatment of second-trimester miscarriages is scarce. We studied the outcomes, and the factors associated with adverse events and need for hospital resources in the medical treatment of second-trimester miscarriage.In these retrospective analyses we studied women treated for spontaneous fetal miscarriage with misoprostol-only (n = 24) or mifepristone and misoprostol (n = 177) in duration of gestation 12+1-21+6. Primary outcomes were the risk factors for surgical evacuation and excessive bleeding. Secondary outcomes were total misoprostol dose, time to expulsion and the length of hospital stay.History of surgical evacuation of the uterus increased the risk of surgical evacuation (p = 0.027). Excessive bleeding was not associated with any of the studied variables. More misoprostol was needed when the duration of gestation exceeded 17+0 weeks (p = 0.036). In multivariate analysis the time to fetal expulsion was shorter in women with history of 1-2 deliveries (hazard ratio [HR] 1.49, 95% confidence interval [CI]; 1.07-2.07), ≥3 deliveries (HR 1.63, 95% CI; 1.11-2.38) and with a two-day interval between mifepristone-misoprostol administration (HR 1.71, 95% CI; 1.05-2.81). Patients with symptoms (i.e. uterine bleeding or pain) at baseline had longer hospital stay (HR 0.66, 95% CI; 0.47-0.92).The factors affecting the outcomes of medical treatment of second-trimester fetal miscarriage are similar to those of second-trimester induced abortion. Two-day interval between mifepristone-misoprostol administration might decrease the time to fetal expulsion and the need of hospital resources. |
| first_indexed | 2024-12-12T20:17:37Z |
| format | Article |
| id | doaj.art-f3757d9439544a3e8614e44ea1746d46 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T20:17:37Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-f3757d9439544a3e8614e44ea1746d462022-12-22T00:13:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01127e018219810.1371/journal.pone.0182198Medical treatment of second-trimester fetal miscarriage; A retrospective analysis.Maarit NiinimäkiMaarit MentulaReetta JahangiriJaana MännistöAnnina HaverinenOskari HeikinheimoResearch on the treatment of second-trimester miscarriages is scarce. We studied the outcomes, and the factors associated with adverse events and need for hospital resources in the medical treatment of second-trimester miscarriage.In these retrospective analyses we studied women treated for spontaneous fetal miscarriage with misoprostol-only (n = 24) or mifepristone and misoprostol (n = 177) in duration of gestation 12+1-21+6. Primary outcomes were the risk factors for surgical evacuation and excessive bleeding. Secondary outcomes were total misoprostol dose, time to expulsion and the length of hospital stay.History of surgical evacuation of the uterus increased the risk of surgical evacuation (p = 0.027). Excessive bleeding was not associated with any of the studied variables. More misoprostol was needed when the duration of gestation exceeded 17+0 weeks (p = 0.036). In multivariate analysis the time to fetal expulsion was shorter in women with history of 1-2 deliveries (hazard ratio [HR] 1.49, 95% confidence interval [CI]; 1.07-2.07), ≥3 deliveries (HR 1.63, 95% CI; 1.11-2.38) and with a two-day interval between mifepristone-misoprostol administration (HR 1.71, 95% CI; 1.05-2.81). Patients with symptoms (i.e. uterine bleeding or pain) at baseline had longer hospital stay (HR 0.66, 95% CI; 0.47-0.92).The factors affecting the outcomes of medical treatment of second-trimester fetal miscarriage are similar to those of second-trimester induced abortion. Two-day interval between mifepristone-misoprostol administration might decrease the time to fetal expulsion and the need of hospital resources.http://europepmc.org/articles/PMC5533459?pdf=render |
| spellingShingle | Maarit Niinimäki Maarit Mentula Reetta Jahangiri Jaana Männistö Annina Haverinen Oskari Heikinheimo Medical treatment of second-trimester fetal miscarriage; A retrospective analysis. PLoS ONE |
| title | Medical treatment of second-trimester fetal miscarriage; A retrospective analysis. |
| title_full | Medical treatment of second-trimester fetal miscarriage; A retrospective analysis. |
| title_fullStr | Medical treatment of second-trimester fetal miscarriage; A retrospective analysis. |
| title_full_unstemmed | Medical treatment of second-trimester fetal miscarriage; A retrospective analysis. |
| title_short | Medical treatment of second-trimester fetal miscarriage; A retrospective analysis. |
| title_sort | medical treatment of second trimester fetal miscarriage a retrospective analysis |
| url | http://europepmc.org/articles/PMC5533459?pdf=render |
| work_keys_str_mv | AT maaritniinimaki medicaltreatmentofsecondtrimesterfetalmiscarriagearetrospectiveanalysis AT maaritmentula medicaltreatmentofsecondtrimesterfetalmiscarriagearetrospectiveanalysis AT reettajahangiri medicaltreatmentofsecondtrimesterfetalmiscarriagearetrospectiveanalysis AT jaanamannisto medicaltreatmentofsecondtrimesterfetalmiscarriagearetrospectiveanalysis AT anninahaverinen medicaltreatmentofsecondtrimesterfetalmiscarriagearetrospectiveanalysis AT oskariheikinheimo medicaltreatmentofsecondtrimesterfetalmiscarriagearetrospectiveanalysis |