Spontaneous abortion: a randomized, controlled trial comparing surgical evacuation with conservative management using misoprostol
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Published on: February 3, 2026
T K Chung1, D T Lee, L P Cheung
1Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, NT. tonychung@cuhk.edu.hk
Objective:
To compare the efficacy of surgical evacuation of the uterus with medical evacuation using misoprostol in cases of spontaneous abortion.
Design:
A prospective, randomized, controlled trial.
Setting:
A university teaching hospital.
Patient(S):
Six hundred thirty-five women who aborted spontaneously and who consented to pretreatment randomization.
Intervention(S):
Routine surgical evacuation or medical evacuation of the uterus using misoprostol.
Main Outcome Measure(S):
Immediate, short-term (2-3 weeks), and medium-term (6 months) medical complications.
Result(S):
There was a significantly lower incidence of immediate and short-term complications in the group treated with misoprostol compared with the surgically treated group. There were also fewer major complications in the 6 months after treatment in the medically treated group. Approximately 50% of the medically treated group subsequently required surgical evacuation, and these subjects required significantly more analgesia.
Conclusion(S):
Treatment with misoprostol can reduce the demand for surgical evacuation in cases of spontaneous abortion, and its use is associated with fewer medical complications.