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Quality of life and acceptability of medical versus surgical management of early pregnancy failure†

  1. B Harwood1,*,
  2. T Nansel2,
  3. for the National Institute of Child Health and Human Development Management of Early Pregnancy Failure Trial‡

Article first published online: 6 FEB 2008

DOI: 10.1111/j.1471-0528.2007.01632.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 115, Issue 4, pages 501–508, March 2008

Additional Information

How to Cite

Harwood, B., Nansel, T. and for the National Institute of Child Health and Human Development Management of Early Pregnancy Failure Trial (2008), Quality of life and acceptability of medical versus surgical management of early pregnancy failure. BJOG: An International Journal of Obstetrics & Gynaecology, 115: 501–508. doi: 10.1111/j.1471-0528.2007.01632.x

Author Information

  1. 1

    Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine, Chicago, IL, USA

  2. 2

    National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD, USA

  1. ‡

    The National Institute of Child Health and Human Development Management of Early Pregnancy Failure Trial investigators and their respective institutions are listed in the acknowledgements.

*Dr B Harwood, Department of Obstetrics and Gynecology, 820 South Wood Street, room 217, MC 808, Chicago, IL 60612, USA. Email brynah@uic.edu

  • †

    This research was presented in part at the joint 2005 Annual Meeting of the Association of Reproductive Health Professionals and the Society of Family Planning, Washington, DC.§

Publication History

  1. Issue published online: 6 FEB 2008
  2. Article first published online: 6 FEB 2008
  3. Accepted 15 November 2007.

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Keywords:

  • Early pregnancy failure;
  • misoprostol;
  • quality of life

Objective  This study compares quality of life (QOL) and acceptability of medical versus surgical treatment of early pregnancy failure (EPF).

Design  A randomised clinical trial of treatment for EPF compared misoprostol vaginally versus vacuum aspiration (VA).

Setting  A multisite trial at four US Urban University Hospitals.

Population  A total of 652 women with an EPF were randomised to treatment.

Methods  Participants completed a daily symptom diary and a questionnaire 2 weeks after treatment.

Main outcome measures  The questionnaire assessment included subscales of the Short Form-36 Health Survey Revised for QOL and measures of wellbeing, recovery difficulties, and treatment acceptability.

Results  The two groups did not differ in mean scores for QOL except bodily pain; medical treatment was associated with higher levels of bodily pain than VA (P < 0.001). Success of treatment was not related to QOL, but acceptability of the procedure was decreased for medical therapy if unsuccessful (P = 0.003). Type of treatment was not associated with differences in recovery, and the two groups reported similar acceptability except for cramping (P = 0.02), bleeding (P < 0.001), and symptom duration (P = 0.03).

Conclusions  Despite reporting greater pain and lower acceptability of treatment-related symptoms, QOL and treatment acceptability were similar for medical and surgical treatment of EPF. Acceptability, but not QOL, was influenced by success or failure of medical management.

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