Randomized trial comparing expectant management and medical management in women diagnosed with retained products of conception after first trimester induced abortion

An open label randomized controlled trial (RCT) of all women diagnosed with retained product of conception (RPOC) after first trimester medical TOP in a single university affiliated medical center. All consecutive women who underwent medical TOP by mifepristone and misoprostol at gestational age under 63 days from last menstrual period and were diagnosed with RPOC in a routine 3-week ultrasound follow-up are offered to participate. RPOC is defined as thick irregular endometrium (over 12 mm) with positive Doppler flow. Following recruitment, patients are randomized into either expectant arm or medical arm (800 mcg misoprostol). The primary outcome measure is RPOC rate in repeat ultrasound scan performed 5 weeks after randomization.

Inclusion Criteria:

• 18 < age < 45 year old
• Thick irregular endometrium >12 mm on trans-vaginal ultrasound

Exclusion Criteria:

• Endometritis
• Cervical opening > 1 cm
• Uterine abnormalities
• Contraindication to Misoprostol treatment

on line sharing via secured system

2 years

for research purposes only