Sven Nielsen

Randomised trial comparing expectant with medical management for first trimester miscarriages

Objective To compare the efficacy of antiprogesterone (mifepristone) in combination with a synthetic prostaglandin E, analogue (misoprostol) for outpatient treatment of miscarriages.

Fertility after a randomised trial of spontaneous abortion managed by surgical evacuation or expectant treatment

present in the follow-up group and both had given birth to children; and in five of the women originally managed surgically, three were followed up and two had given birth to children. 14 of the 76 women who attempted to become pregnant, most of whom were managed by expectant management, underwent operative evacuation at a later date due to retained products. The cumulative conception rates in women managed expectantly who later required surgical evacuation for retained products, expectantly only, and primary evacuation were 93%, 91%, and 88%, respectively. This follow-up study shows that expectant management of spontaneous abortion does not affect future fertility.

Unsuccessful treatment of missed abortion with a combination of an antiprogesterone and a prostaglandin E1 analogue

In a prospective clinical trial the effectiveness of a combination of 400 mg of mifepristone (antiprogesterone) and 400 g misoprostol (synthetic prostaglandin E1 analogue), both taken orally, was evaluated for the treatment of missed abortion. Of the 31 patients included, 16 (52%) had an empty uterine cavity at follow up six days after inclusion, 11 (35%) required surgical evacuation for retained intrauterine products of conception found at follow up, and four (13%) required emergency surgical evacuation due to severe pain or bleeding. The results do not support the use of mifepristone and misoprostol for women wishing the miscarriage to be resolved quickly.

Using a logistic model to identify women with first-trimester spontaneous abortion suitable for expectant management

Objective To design a method to identify women with first trimester spontaneous abortion suitable for expectant management.

Expectant management of first-trimester miscarriage in clinical practice

Background.  The aim of this study was to evaluate treatment efficacy and patient compliance in women with an early miscarriage managed expectantly in routine clinical practice.

A randomised double blind trial comparing misoprostol or placebo in the management of early miscarriage

Objectives  To study if misoprostol 400 μg, administered vaginally, increased the successful resolution of early miscarriage compared with placebo.

Bishop score and the outcome of labor induction with misoprostol.

Background. The aim of the study was to retrospectively identify possible factors for predicting the outcome of induction with misoprostol.