UK 1999

Trial name or title	Miscarriage Treatment Study (MIST).
Methods
Participants	Women with confirmed missed and incomplete miscarriage attending early pregnancy clinics, with gestational dates less than 91 days (13 weeks), or uterine cavity volume being less than 91 days. Other inclusion criteria: women can understand English, willing to be randomised to any treatment group and there is uncertainty about the best management. Exclusion criteria: severe haemorrhage, severe pain, pyrexia above 37.5 C, severe asthma, blood dyscrasia, diabetes, current anticoagulants or corticosteroid therapy, twin or higher order pregnancy, use of prostaglandin contra‐indicated, cannot understand written English, refuses written consent.
Interventions	Expectant group: sent home with written advice and analgesia. Medical group: will be admitted (immediately if incomplete miscarriage and 24‐48 hours after oral administration of mifepristone if missed miscarriage) and vaginal misoprostol will be administered. Surgical group: as is current practice.
Outcomes	Primary outcome measure: (1) gynecological infection within 14 days of the confirmation of miscarriage by TVS. Secondary outcome measures: (1) treatment with antibiotic (within 14 days and 6 weeks); (2) days of pain, days of vaginal bleeding, time off work, return to usual daily activities; (3) haemoglobin and packed cell volume (both at 10‐14 days), unplanned surgical ERPC or other admission (within 14 days or 6 weeks); (4) complete evacuation of the uterus by TVS (at 10‐14 days); (5) depression anxiety and general health (at 6 weeks).
Starting date
Contact information	Miss Lohanna Trinder MIST Study Co‐ordinating Center Dept of Women's Health Cotswold Center Southmead Hospital Bristol BS10 5NB UK Tel: 01179595186 FAX 01179595178 e‐mail: jo_trinder@msn.com.uk
Notes

ERPC: evacuation of retained products of conception TVS: transvaginal sonography