Medical management of first trimester miscarriage: a quality improvement initiative.

Abstract

INTRODUCTION:

Medical management of first trimester pregnancy loss is a safe option that is well tolerated and affords women more autonomy in relation to their care. Recent trials provide robust evidence that mifepristone pretreatment is the optimal approach for women with missed miscarriage who desire medical management.

METHODS:

Following a change in medical management of first trimester miscarriage in our unit, we conducted a retrospective audit over a 3-month period of all women who had elected medical management as their primary treatment option. We compared the results with a previous audit that had been undertaken prior to the change in practice.

RESULTS:

The implementation of mifepristone resulted in an increased effectiveness of primary medical treatment for first trimester miscarriage from 53.8% to 85.2% (p=<0.001).

DISCUSSION:

The results of our study support the introduction of mifepristone into routine clinical practice for medical management of first trimester pregnancy loss across all maternity units.

• Authors: Deirdre Hayes-Ryan, Sharon Cooley, Brian Cleary
• Journal: European journal of hospital pharmacy : science and practice (Eur J Hosp Pharm) Vol. 31 Issue 1 Pg. 70-72 (Dec 27 2023) ISSN: 2047-9956 [Print] England
• PMID: 34426487 (Publication Type: Journal Article)
• Copyright: © European Association of Hospital Pharmacists 2024. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Mifepristone
• Misoprostol

Topics

• Pregnancy
• Female
• Humans
• Abortion, Spontaneous (epidemiology, drug therapy)
• Pregnancy Trimester, First
• Mifepristone (therapeutic use)
• Misoprostol (therapeutic use)
• Quality Improvement
• Retrospective Studies