{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:48:59Z","timestamp":1790315339418,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T00:00:00Z","timestamp":1634083200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To compare the short\u2010 and long\u2010term emotional distress (grief, anxiety and depressive symptoms) after early miscarriage and satisfaction with treatment between women randomized to expectant management\n                      <jats:italic>vs<\/jats:italic>\n                      vaginal misoprostol treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a preplanned analysis of data collected during a randomized controlled trial comparing expectant management with misoprostol treatment in women with early anembryonic or embryonic miscarriage and vaginal bleeding. If the miscarriage was not complete on day\u200931 after inclusion, surgical evacuation was recommended. The main outcomes were levels of anxiety and grief, depressive symptoms and client satisfaction with the treatment, which were assessed using the following validated psychometric self\u2010assessment instruments: Spielberger State\u2013Trait Anxiety Inventory (STAI, Form Y), Perinatal Grief Scale (PGS), Montgomery\u2013\u00c5sberg Depression Rating Scale (MADRS\u2010S; self\u2010reported version) and Client Satisfaction Questionnaire (CSQ\u20108). All women were assessed at four timepoints: on the day of randomization, on the day when the miscarriage was judged to be complete, and at 3\u2009months and 14\u2009months after complete miscarriage. The psychometric and client satisfaction scores were compared between the misoprostol group and the expectant\u2010management group at each assessment. Analysis was performed by the intention\u2010to\u2010treat principle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety women were randomized to expectant management and 94 to misoprostol treatment. The psychometric and client satisfaction scores were similar in the two treatment groups at all assessment timepoints. At inclusion, 41% (35\/86) of the women managed expectantly and 37% (34\/92) of those treated with misoprostol had a STAI\u2010state score of &gt;\u200946 (\u2018high level of anxiety\u2019), and 9% (8\/86) and 10% (9\/91), respectively, had symptoms of moderate or severe depression (MADRS\u2010S score \u2265\u200920). In both treatment groups, symptom scores for anxiety and depression were significantly higher at inclusion than after treatment and remained low until 14\u2009months after complete miscarriage. Grief reactions were mild in both groups, with a median PGS score of 40.0 at 3\u2009months and 37.0 at 14\u2009months after complete miscarriage in both treatment groups. Four women treated with misoprostol and two women managed expectantly had a PGS score of &gt;\u200990 (indicating deep grief) 3\u2009months after complete miscarriage, while one woman managed expectantly had a PGS score of &gt;\u200990 14\u2009months after complete miscarriage. Women in both treatment groups were satisfied with their management, as indicated by a median CSQ\u20108 score of &gt;\u200925 at each assessment. More than 85% of participants in each of the two groups reported that they would recommend the treatment they received to a friend.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The psychological response to and recovery after early miscarriage did not differ between women treated with misoprostol and those managed expectantly. Satisfaction with treatment was high in both treatment groups. Our findings support patient involvement when deciding on the management of early miscarriage. \u00a9 2021 The Authors. Ultrasound in Obstetrics &amp; Gynecology published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.23641","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T13:29:43Z","timestamp":1617370183000},"page":"757-765","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Psychological impact of early miscarriage and client satisfaction with treatment: comparison between expectant management and misoprostol treatment in a randomized controlled trial"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1773-9488","authenticated-orcid":false,"given":"A.","family":"Fernlund","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Sk\u00e5ne University Hospital  Malm\u00f6 Sweden"},{"name":"Department of Clinical 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