Bleeding patterns after misoprostol vs surgical treatment of early pregnancy failure: results from a randomized trial

Anne R. Davis, Sarah K. Hendlish, Carolyn Westhoff, Margaret M. Frederick, Jun Zhang, Jerry M. Gilles, Kurt Barnhart, Mitchell D Creinin

Research output: Contribution to journalArticle

30 Scopus citations


Objective: The purpose of this study was to describe bleeding patterns after misoprostol or curettage for early pregnancy failure (EPF). Study design: This was a randomized trial that included women (n = 652) with EPF. Participants were assigned to vaginal misoprostol (800 μg) or curettage in a 3:1 ratio. Participants completed a bleeding diary. We measured hemoglobin levels at baseline and 2 weeks after the treatment. Results: Decreases in hemoglobin levels were greater after misoprostol (-0.7 g/dL; SD, 1.2) than curettage (-0.2 g/dL; SD, 0.9; P < .001). Large changes in hemoglobin levels (at least 2 g/dL) or low nadir hemoglobin levels (< 10 g/dL) were more frequent after misoprostol (55/428 women; 12.8%) than after curettage (6/135 women; 4.4%; P = .02). More participants in the misoprostol group reported "any bleeding" or "heavy bleeding" every study day. Four women who were treated with misoprostol required blood transfusion. Conclusion: Bleeding is heavier and more prolonged after medical treatment with misoprostol than with curettage for EPF; however, bleeding rarely requires intervention.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Issue number1
StatePublished - Jan 2007
Externally publishedYes



  • curettage
  • early pregnancy failure
  • miscarriage
  • misoprostol

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

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