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.

Full Abstract

OBJECTIVES: To compare fertility rates after the three methods of managing early miscarriage in women recruited to the MIST (miscarriage treatment) randomised controlled trial. SETTING: Early pregnancy clinics of acute hospitals in the south west region of England. PARTICIPANTS: 1199 women who had had an early miscarriage (<13 weeks) confirmed by scan. INTERVENTION: Expectant, medical, or surgical management. MAIN OUTCOME MEASURES: Self reported pregnancy rates and live birth rates. RESULTS: Of 1199 women recruited to the trial, 1128 consented to follow-up. Of these, 762 women replied giving pregnancy details (68% response rate). Respondents were representative of the trial participants. The live birth rate five years after the index miscarriage was similar in the three management groups: 177/224 (79%, 95% confidence interval 73% to 84%) in the expectant management group, 181/230 (79%, 73% to 84%) in the medical group, and 192/235 (82%, 76% to 86%) in the surgical group. There was also no significant difference according to previous birth history. Older women and those with previous miscarriages were significantly less likely to subsequently give birth. CONCLUSION: 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. Women can be reassured that long term fertility concerns need not affect their choice of miscarriage management. TRIAL REGISTRATION: National Research Register N0467011677/N0467073587.

Author information

Author/s: Smith, Lindsay F P (LF); Ewings, Paul D (PD); Quinlan, Catherine (C);

Affiliation: East Somerset Research Consortium, Westlake Surgery, West Coker, Somerset BA22 9AH. research(-atsign-)esrec.nhs.uk

Journal and publication information

Publication Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: BMJ (Clinical research ed.) (BMJ), published in England. (Language: eng)

Reference: 2009-; vol 339 (issue ) : pp b3827

Dates: Created 2009/10/09; Completed 2009/10/28;

PMID: 19815581, status: MEDLINE (last retrieval date: 10/28/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.