MIST follow up Flashcards
1
Q
Journal
year
A
BMJ 2009
2
Q
Aims
A
To compare fertility rates after the 3 methods of managing early miscarriage in women
3
Q
Study Design
A
RCT
4
Q
Participants
A
- Early pregnancy clinics of acute hospitals in south west region of England
- 1199 women who had had an early miscarriage (<13/40) confirmed on scan
- 1128 consented to follow-up
- Of these 762 women replied giving pregnancy details (68% response rate)
5
Q
Intervention
A
Expectant, medical, or surgical management
6
Q
Primary end-points
A
Self reported pregnancy rates and live birth rates
7
Q
Summary of results
A
- Live birth rates 5 years after the index miscarriage was similar in 3 management groups
o 79% expectant
o 79% medical
o 82% surgical - No significant difference according to previous birth history
- Older women and those with previous miscarriages were significantly less likely to subsequently give birth
8
Q
Limitations
A
- Sending out questionnaires (but responders were similar to initial trial demographic and still included women who did not want to conceive after index miscarriage)
- Only 68% response rate
- Relied on self-reporting of pregnancy
9
Q
Conclusion
A
- Method of miscarriage management does not affect subsequent pregnancy rates
- 4 in 5 women giving birth within 5 years of index miscarriage
- Women can be reassured that long term fertility concerns need not affect their choice of miscarriage management
10
Q
What is already known on this topic
A
- All 3 of the methods of management of early miscarriage currently offered to women in the UK and elsewhere are probably equivalent in terms of gynaecological infection
- Little published evidence has assessed the effect of management method on subsequent fertility – a key issues for women and those who care for them
11
Q
What this study adds
A
- Type of management method does not affect subsequent fertility, with around 80% of women having a live birth within 5 years of the index miscarriage
