TABLE 3.

Inclusion and exclusion criteria.

Author, year	Inclusion	Exclusion
Country
Acharya, 2002 UK	All patients with a confirmed first‐trimester missed miscarriage who chose to undergo expectant management
Banerjee, 2013 UK	Ultrasound confirmed missed miscarriage (crown‐rump length <6 mm with no fetal heart beat) or early fetal demise (gestational sac diameter >20 mm without fetal pole or yolk sac) Upper limit for gestational age was 12 weeks by menstrual date or by ultrasound scan	If active vaginal bleeding Previously received medical management for miscarriage in the current pregnancy
Casikar, 2013 Australia	Women diagnosed with incomplete, missed, and empty sac miscarriage were included An incomplete miscarriage was defined as the presence of heterogeneous tissue seen on ultrasound within the uterine cavity and distorting the endometrial midline echo Missed miscarriage was defined as the presence of a crown‐rump length (CRL) </=6 mm with absent fetal heart activity seen on ultrasound An empty sac was defined as a gestational sac diameter >20 mm with no visible CRL seen on ultrasound	Severe vaginal hemorrhage with hemodynamic instability, Infection Complete miscarriage diagnosed at the first scan (in the context of a previously documented intrauterine pregnancy) Molar pregnancy Missed miscarriage diagnosed at the nuchal translucency (NT) scan Missed miscarriage when the crown‐rump length (CRL) was 3 weeks smaller than the gestational age based on the last menstrual period (LMP)
Casikar, 2013 Australia	Women diagnosed with incomplete, missed, and empty sac miscarriage were included An incomplete miscarriage was defined as the presence of heterogeneous tissue seen on ultrasound within the uterine cavity and distorting the endometrial midline echo Missed miscarriage was defined as the presence of a crown‐rump length (CRL) </=6 mm with absent fetal heart activity seen on ultrasound An empty sac was defined as a gestational sac diameter >20 mm with no visible CRL seen on ultrasound	Severe vaginal hemorrhage with hemodynamic instability Infection Complete miscarriage diagnosed at the first scan (in the context of a previously documented intrauterine pregnancy) Molar pregnancy Missed miscarriage diagnosed at the nuchal translucency (NT) scan Missed miscarriage when the crown‐rump length (CRL) was 3 weeks smaller than the gestational age based on the last menstrual period (LMP)
Casikar, 2010 Australia	Women diagnosed with incomplete, missed, and empty sac miscarriage were included An incomplete miscarriage was defined as the presence of heterogeneous tissue seen on ultrasound within the uterine cavity and distorting the endometrial midline echo Missed miscarriage was defined as the presence of a crown‐rump length (CRL) </=6 mm with absent fetal heart activity seen on ultrasound An empty sac was defined as a gestational sac diameter >20 mm with no visible CRL seen on ultrasound	Severe vaginal hemorrhage with hemodynamic instability, Infection Complete miscarriage diagnosed at the first scan (in the context of a previously documented intrauterine pregnancy) Molar pregnancy Missed miscarriage diagnosed at the nuchal translucency (NT) scan Missed miscarriage when the crown‐rump length (CRL) was 3 weeks smaller than the gestational age based on the last menstrual period (LMP)
Casikar, 2012 Australia	Diagnosis of incomplete miscarriage: defined by the presence of a measurable focus of hyperechoic material within the endometrial cavity using two‐dimensional (2D) greyscale TVS Hemodynamic stability Absence of infection	Severe vaginal hemorrhage or hemodynamic instability Signs of infection: temperature, tachycardia, offensive vaginal loss and lower abdominal tenderness
Creinin, 2006 USA	Women who had an anembryonic gestation or embryonic/fetal demise were eligible for inclusion if they had an ultrasound examination demonstrating an embryonic pole or crown‐rump length between 5 and 40 mm without cardiac activity, an anembryonic gestational sac with a mean diameter between 16 and 45 mm, growth of gestational sac less than 2 mm over 5 days or less than 3 mm over 7 days, or an increase in human chorionic gonadotropin by less than 15% over 2 days with a yolk sac visualized by ultrasound examination Women who had incomplete or inevitable miscarriages were also included Incomplete spontaneous miscarriage was defined as passage of some products of conception with the residual anterior–posterior endometrial lining greater than 30 mm by transvaginal ultrasonography and uterine size less than 13 weeks. This cut‐off was based on evidence from prior studies of women treated with misoprostol for medical miscarriage or early pregnancy failure Inevitable miscarriage was defined as an intrauterine gestational sac less than 45 mm or embryonic pole less than 40 mm and an open internal cervical os to digital examination with active vaginal bleeding	Women were excluded from the primary study if they were: anemic (hemoglobin level below 9.5 mg/dL) hemodynamically unstable history of a clotting disorder using anticoagulants allergic to prostaglandins or nonsteroidal anti‐inflammatory drugs previously undergone surgical or medical miscarriage, either self‐induced or by other physicians during the current pregnancy
Elson, 2005 UK	A diagnosis of missed miscarriage was made if the size of gestational sac was >20 mm in diameter with no visible embryo; if the fetal crown–rump length was >5 mm with no detectable fetal heart rate; or if the gestational sac had failed to develop on a follow‐up scan >6 days after the initial examination An incomplete miscarriage was diagnosed in women with a history of bleeding, who had no visible gestational sac on ultrasound scan, but there was clear evidence of retained trophoblast tissue within the uterine cavity All clinically stable women with history of mild lower abdominal pain and bleeding and a conclusive ultrasound diagnosis of miscarriage were offered expectant management
Fernlund, 2020 Sweden	≥18 years old understanding written and spoken Swedish hemoglobin concentration >80 g/L no contraindications to misoprostol treatment fulfilling ultrasound criteria of anembryonic or embryonic miscarriage fetal crown‐rump‐length ≤33 mm	Women with heavy bleeding needing urgent surgical evacuation of the uterine cavity, as judged clinically, were not eligible
Grewal, 2019 UK	Women presented after miscarriage with the following clinical scenarios: incomplete miscarriage (n = 23), failed medical management of miscarriage with RPOC (n = 8) and failed surgical management of miscarriage (n = 9) EMV was defined as a hypervascular area within the myometrium, detected on transvaginal color Doppler ultrasonography with a PSV on pulsed Doppler of ≥20 cm/s, within the collection of vessels
Guedes‐Martins, Portugal 2015	Cases of early pregnancy loss, defined as intrauterine pregnancy with reproducible evidence of lost fetal heart activity and/or the lack of increased crown–rump length over one week or the persisting presence of an empty sac at less than 12 weeks of gestation Clinically stable women	Ectopic pregnancy Complete or incomplete pregnancy Known allergy to prostaglandins or NSAIDs Multiple gestation Heavy vaginal bleeding Hemodynamic instability Blood clotting problems or current treatment with anticoagulants Hb <10 Body temperature >38 degrees CRL >12 weeks gestation Prostaglandin contraindications, including uncontrolled blood pressure, mitral stenosis, severe asthma, or glaucoma
Hamel, 2022 Netherlands	Women aged 16 years or older Diagnosed with a non‐viable intrauterine pregnancy between 6 and 14 weeks of gestational age	Women who were clinically unfit for medical management Women with a miscarriage in progress (defined as increasing or heavy vaginal bleeding and/or abdominal cramping) or with an incomplete miscarriage
Lavecchia, 2015 Canada	ED discharge prescription for medical management	Women whose medical charts lacked their sonograms
Luise, 2002 UK (BMJ)	Women with retained products of conception opting for expectant management	Molar pregnancy
Luise, 2002 UK (UOG)	All women with a spontaneous, incomplete miscarriage before the 13th week of gestation	Molar pregnancy
Lusink, 2018 Australia	The crown rump length should be ≤25 mm and the MGSD ≤50 mm The woman should have no medical contraindications to misoprostol and have adequate social support at home	Received mifepristone Protocol violations Incomplete records
Sairam, 2001 UK	Incomplete miscarriage was diagnosed when the endometrial thickness was more than 5 mm with loss of midline echo suggestive of retained products. Missed miscarriage was diagnosed when either the mean diameter of the empty gestation sac was ≥20 mm (anembryonic gestation) or when the crown rump length was ≥7 mm without a detectable heart beat (missed miscarriage)	Heavy vaginal bleeding Severe abdominal pain Clinical evidence of intrauterine infection Suspected molar/ectopic pregnancy Other medical complications Gestation age greater than 14 weeks
Sajan, 2020 India	Anembryonic pregnancy: Gestational sac mean diameter of at least 25 mm with no embryonic/extra embryonic structures present Early fetal demise (EFD): CRL of at least 7 mm with no cardiac activity, or no change in size on weekly serial scanning Incomplete miscarriage: Disrupted endometrial echo measuring more than 15 mm measured in the anteroposterior plane, with the presence of heterogeneous and irregular tissues	Gestational age more than13 weeks Severe vaginal bleeding Severe abdominal pain Hemodynamic instability at presentation Fever Chronic illness
Schreiber, 2015 USA	Women presenting with first trimester pregnancy failure (anembryonic pregnancy, embryonic demise, incomplete miscarriage, and inevitable miscarriage)
Schwarzler, 1999 UK	Pregnancies with an estimated gestation age of <13 weeks from the last menstrual period (LMP) were included. All women included in the study were symptomatic and had reported vaginal bleeding and/or abdominal pain. Those shown by ultrasonography to have either a missed miscarriage or an anembryonic pregnancy	Severe hemorrhage or pain Pyrexia above 37.5°C Severe asthma Hemolytic disease or blood dyscrasias Current anticoagulation or systemic corticosteroid treatment Twin or higher order pregnancy Smoker aged over 35 Inability to understand written English
Trinder, 2006 UK	Women with a pregnancy of less than 13 weeks' gestation Diagnosed as having either an incomplete miscarriage (defined an incomplete miscarriage as areas of mixed echogenicity within the uterine cavity with or without a disordered gestation sac) or early fetal/embryonic demise (defined early embryonic demise as an intact gestation sac of greater than 20 mm mean diameter with no other internal structures and early fetal demise as a fetus of over 6 mm crown rump length with no heart activity on transvaginal ultrasound scan)
Sonalkar, 2021 USA	Women 18 years and older Diagnosed with a nonviable intrauterine pregnancy (anembryonic gestation or embryonic/fetal demise) Between 5 and 12 weeks gestation	Diagnosis: incomplete or inevitable miscarriage Women clinically ineligible for EPL medical management
Vejborg, 2007 Denmark	Group A missed miscarriage: a foetus of at least 6 mm (crown rump length; CRL) without cardiac activity (Group A1) or a foetus <6 mm and either no growth or development of cardiac activity over 1 week or declining hCG values (Group A2) or Group B_anembryonic pregnancy: either an empty gestational sac of at least 18 mm (Group B1) or an empty gestational sac of <18 mm with no growth over at least 7 days or a declining hCG value (Group B2)	Twin pregnancies
Wada, 2021 Japan	Patients who had spontaneously or artificially aborted before 22 weeks of gestation RPOC diagnosis was made by ultrasound as follows: (1) an intrauterine high‐echoic or heterogenetic lesion adjacent to the myometrium, (2) a hypervascular lesion in the uterine cavity

Abbreviations: CRL, crown rump length; ED, emergency department; EFD, early fetal demise; EMV, enhanced myometrial vascularity; EPL, early pregnancy loss; Hb, hemoglobin; LMP, last menstrual period; MSGD, mean gestational sac diameter; NSAID, non‐steroidal anti inflammatory drug; NT, nuchal translucency; PSV, peak systolic velocity; RPOC, retained products of conception; TVS, transvaginal scan.