Cost-Effectiveness of Curettage Versus Expectant Management in Women With an Incomplete Evacuation After Misoprostol Treatment for First-Trimester Miscarriage: A Randomized Controlled Trial and Cohort Study

摘要

Misoprostol was introduced over 10 years ago as a treatment option for women with first-trimester miscarriages alongside expectant management and curettage. It is an effective treatment for 50% to 85% of these women. Several studies have reported that misoprostol is cost-effective for miscarriage in comparison with curettage, although this result was not confirmed by other investigators. The MisoRESTstudy, a randomized controlled trial, compared curettage and expectant management in women with incomplete evacuation of the uterus after misoprostol treatment for first-trimester miscarriage. The results showed significantly more women with an empty uterus after curettage than after expectant management. Considering the high costs associated with curettage compared with expectant management, it is important to evaluate whether the additional costs of curettage in women with incomplete evacuation are justified by the additional clinical effects. The cost-effectiveness of curettage compared with expectant management is unknown in this population.