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. 2019 Jun 17;2019(6):CD002253. doi: 10.1002/14651858.CD002253.pub4
Study Reason for exclusion
Abbas 2018 Participants do not meet inclusion criteria (includes women undergoing termination of pregnancy for other reasons than non vital pregnancies, and up to a GA of 27 weeks).
Abd‐El‐Maeboud 2012 Termination of 'viable' pregnancies; the intervention is priming before medical treatment and not the treatment itself.
Abdel Fattah 1997 Conference abstract. No information about GA but, given title, probably includes pregnancies > 24 weeks as well as < 24 weeks.
Al‐Bdour 2007 Quasi‐randomised trial, patients assigned to treatment according to military ID number.
Ali 2018 Different topic, study includes women induced with balloon catheters and not with medication.
Almog 2005 Termination of 'viable' pregnancies ‐ mainly with fetal anomalies.
Altaf 2006 Not a randomised study. No subgroup analysis with only patients with missed abortion and GA < 24 weeks.
Amjad 1999 Other subject; ‘priming’ of cervix while Foley catheter in situ.
Anderman 2000 Conference abstract. Includes pregnancies > 24 weeks as well as < 24 weeks.
Anderson 2009 Conference abstract. Duration of pregnancy unclear.
Ara 2009 Conference abstract.
Arellano 2009 Conference abstract on other subject. Treatment of incomplete abortion.
Avila‐Vergara 1997 Intrauterine deaths mainly third trimester.
Aye 2017 Conference abstract, further results not published. It is not clear if also women with incomplete miscarriage were included in this study.
Azra 2007 Termination of pregnancies for congenital malformations as well as non‐viable pregnancies. No subgroup analyses.
Bagratee 2009 Conference abstract on other subject. Predictive/etiologic study, size of RPOC as predictor of successful treatment.
Bani‐Irshaid 2006 Other subject (TOP); no subgroup analysis of women with GA < 24 weeks.
Bartz 2013 Other subject, randomised trial of 2 methods for dilatation of the cervix before surgical evacuation.
Bebbington 2002 Termination of viable pregnancies.
Behrashi 2008 Includes patients with GA < 24 weeks and > 24 weeks; and patients with 'viable' pregnancies. No subgroup analyses performed. We tried to contact the authors by e‐mail but they could not be reached.
Behrashi 2010 Not a publication of study results but a registration of a RCT in Iranian Trial Register.
Ben‐Meir 2009 RCT comparing priming with misoprostol vs placebo before oxytocin induction. Patients with GA > 24 weeks included.
Betstadt 2007 Registration of trial protocol, no results published. Author was contacted, stated that the trial was stopped prematurely because of a lack of participants.
Bique 2007 Trial concerning treatment of incomplete abortion.
Biswas 2007 Termination of pregnancy because of various reasons, no subgroup analyses on patients with missed miscarriage or early fetal death. We tried to contact the authors but could not reach them.
Blohm 2005 Includes patients with incomplete (ongoing) miscarriage (with gestational residue between 15 mm to 50 mm).
Brouns 2010 Trial also includes patients with legal termination of viable pregnancies. We contacted the authors to ask for subgroup analyses of only patients with non‐viable pregnancies; but the original data were not accessible to them anymore.
Cabrol 1990 Trial of mifepristone for induction of labour after intrauterine death ‐ but mainly late second and third trimester pregnancies.
Caliskan 2005 Includes all patients with indication for termination of pregnancy; but does not state which indications are meant. We tried to contact the authors but could not reach them.
Caliskan 2009 Other subject (termination of pregnancy).
Chaudhuri 2015 Reference of trial registration. Results were published in 2015. Study participants included women with second and third trimester intrauterine fetal death. No subgroup analyses for GA < 24 weeks.
Chowdhury 2012 Conference abstract. No information on GA.
Clevin 2001 Abstract in Danish. A prospective, randomised study carried out to clarify the effect of vaginal administration of a prostaglandin E1 analogue (gemeprost) versus surgical management (curettage) on miscarriages at up to 12 weeks of gestation. 3 groups: 1 (n = 27), 2A (n = 17) and 2B (n = 17), allocated according the endometrial thickness. The measured outcomes were reduction of endometrial thickness, duration of vaginal bleeding and pain, reported in a non‐suitable format for analysis.
Dabash 2009 Conference abstract, other subject (treatment of incomplete abortion).
Dao 2007 Other subject (treatment of incomplete abortion).
Das 2014 Other subject; treatment of incomplete miscarriage.
David 2003 Randomised trial (details of randomisation unclear) of 2 methods to soften the cervix before surgical evacuation for early non‐viable pregnancies. No usable clinical data, given short timescale between treatment and surgery.
David 2005 Other subject (cervical priming before surgical evacuation).
Demirezen 2018 The participants in this study do not meet the inclusion criteria for this review (gestational age up to 28 weeks, and termination of both vital and non vital pregnancies). The intervention studied (induction with different type of balloon catheter) does not meet the inclusion criteria for this review.
Dickinson 1998 Trial included women with fetal malformations and maternal indications for pregnancy termination between 14 and 28 weeks, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Dickinson 2002 Trial included women with fetal malformations and maternal indications for pregnancy termination between 14 and 30 weeks, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Dickinson 2003 Randomised trial comparing oral with vaginal administration of misoprostol to terminate pregnancies with fetal malformations ‐ not non‐viable pregnancies.
Diop 2009 Other subject; treatment of incomplete abortion.
El Sokkary 2016 Unclear up to which GA patients were included and if there were subgroup analyses made for patients with GA eligible for this review. Furthermore, unclear what type of randomisation was used and therefore if this truly was a randomised controlled trial. We tried to contact the author but there was no response.
Elami‐Suzin 2013 Trial included also patients with therapeutic abortion; no subgroup analysis on only missed miscarriage other than 1 remark in text (time until expulsion shorter than therapeutic abortion'; but that is not an outcome in our review). Furthermore, all women underwent curettage after medication, so it would be impossible to draw conclusions about the primary outcome in the review (complete evacuation) because it would be unclear whether the uterus was empty because of the medication or because of the curettage.
Elhassan 2008 Includes patients with GA up to 28 weeks. We e‐mailed the authors to ask for a subgroup analysis of patients with GA < 24 weeks, but they did not respond.
Eppel 2005 Trial included women with fetal malformations and maternal indications for pregnancy termination between 14 and 23 weeks, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Eslamian 2007 Study group also includes patients with maternal medical disorders, TOP because of congenital malformations and PPROM. We contacted the authors: there were no subgroup analyses of only patients with fetal demise.
Fadalla 2004* Women included in this trial had a GA 13‐28 weeks, no subgroup analysis for GA < 24 weeks was available
Feldman 2003 Trial included women with fetal malformations and maternal indications for pregnancy termination between 14 and 23 weeks, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Fernlund 2018 Includes women with ongoing miscarriage (vaginal blood loss in combination with a sonographically diagnosed non vital first trimester pregnancy).
Fiala 2005 Other subject (pain medication in requested abortion for socio‐economic reasons).
Ghorab 1998 Trial included women with fetal malformations for pregnancy termination, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Gonzalez 2001 Trial included women with fetal malformations and maternal indications for pregnancy termination between 14 and 23 weeks, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Grimes 2004 Trial included women with other reasons for pregnancy termination, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Gronland 2002 Not a randomised trial. 3‐centre study of women with non‐viable pregnancies comparing 3 treatment regimens: misoprostol, mifepristone + misoprostol, surgical evacuation ‐ with treatment regimen changing at each hospital every 4 months.
Guix 2005 Trial includes patients seeking termination of pregnancy because of congenital malformations.
Halimi 2004 Trial includes patients with termination of pregnancy because of fetal demise or congenital malformations, up to GA of 28 weeks. No subgroup analyses available.
Hassan 2007 Quasi‐randomised trial; other subject (treatment of incomplete abortion).
Hausler 1997 Prospective RCT evaluating 3 interventions for complete spontaneous abortion. Diagnosis was based on positive pregnant test, vaginal bleeding and/or evacuation of tissue from the vagina, a closed uterine orifice with only slight bleeding on admission and a possible clear sonographic pregnancy diagnosis in the history. Interventions: A) n = 15 curettage; B) n = 20 only controlled and; C) n = 15 additionally treated for 10 days with an oral hormone intake of 2 mg norethisterone acetate and 0.01 mg ethinyl oestradiol 3 x day. Randomisation by sealed unmarked envelopes. 63 patients were included in the study and allocated randomly to each group. 13 women (20.6%) were excluded from the study after randomisation: 10 did not report for the planned follow‐up control, 1 did not report for curettage, in 1 the height of the endometrium was > 8 mm and in 1 an ectopic pregnancy was diagnosed 6 days after the randomisation. The study only presents outcomes, in a non‐suitable format, regarding hCG clearing time and duration of the secondary haemorrhage from the day of randomisation.
Heard 2002 Conference abstract. Unclear what type of randomisation; 12 patients were assigned to group A and 21 to group B which seems odd in cases of 1:1 and even in case of 1:2 randomisation; no further information on methodology. No full article for this trial found.
Herabutya 1997a Includes patients with all GA; no subgroup analyses of only patients with GA < 24 weeks; authors could not be reached for further clarification.
Herabutya 2005 RCT of misoprostol for terminating viable pregnancies.
Hidar 2001 Trial included women with fetal malformations and maternal indications for pregnancy termination between 13 and 29 weeks, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Hidar 2005 Trial includes patients with GA > 29 weeks and patients with TOP because of congenital anomalies or PPROM. We contacted the authors: there were no subgroup analysis available of only patients with intrauterine fetal death.
Hill 1991 Trial includes fetal deaths in both second and third trimesters.
Hinshaw 1993 Henshaw 1995: conference abstract. No subgroup analysis of randomised proportion (trial was partly randomised and partly treatment according to patients preference).
Hinshaw 1993: interim results of partially randomised trial; no subgroup analysis on randomised patients, full results in other article.
Hinshaw 1995: interim results of partially randomised trial; no subgroup analysis on randomised patients, full results in other article.
Rispin 1993: conference abstract concerning study protocol of ongoing study; no results presented.
Hogg 2000 Abstract. Trial included women with other reasons for pregnancy termination, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Hombalegowda 2015 Conference abstract. No article with full results found. We tried to contact the authors to ask for such an article but could not reach them.
Hughes 1996 Cost‐effectiveness analysis of previous study that included patients with incomplete miscarriage (no subgroup analysis on patients with fetal demise); partly randomised trial. We contacted authors for subgroup analysis on RCT patients with fetal demise, however they did not respond.
Imran 2010 Includes patients with GA > 24 weeks and TOP because of congenital malformations. We tried to contact the authors to ask for subgroup analyses but they did not respond.
Islam 2006 Not randomised; patients were divided in 2 equal groups. Trial included patients seeking TOP because of congenital malformations; no subgroup analysis on patients with fetal demise.
Jabir 2009a Conference abstract. Other subject (cervical dilation before surgical evacuation).
Jabir 2009b Conference abstract. Other subject (cervical preparation 3 hours before surgical evacuation).
Jain 1994 Trial included women with fetal malformations and maternal indications for pregnancy termination between 12 and 22 weeks, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Jain 1999 Trial included women with fetal malformations and maternal indications for pregnancy termination between 12 and 22 weeks, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Johnson 1997 RCT evaluating pain and bleeding and comparing surgical to medical treatment. Surgical arm (n = 12) uterine curettage under general anaesthesia. Medical arm (n = 17) include 3 different participant conditions and treatments: a) no treatment if women had a complete abortion and uterine cavity echo (myometrium) less than 15 mm; b) women with incomplete abortion: 1 mg pessary of gemeprost (Cervagem, May and Baker) and remained in hospital for 4 hours or until they had passed POC; and c) women with intact gestational sac (but non‐viable fetus) 200 mg RU 486 (mifepristone) and then allowed home, readmitted 36‐48 hours later for 1 mg of vaginal Cervagem. Data from each subgroup in the medical arm are not separated. The sample size is too small to detect any difference among such number of groups.
Kamal 2005 Quasi‐experimental study, no RCT. Includes patients with GA > 24 weeks and with TOP because of maternal or fetal reasons.
Kanhai 1989 Includes both second and third trimester fetal deaths.
Kapp 2007 Quasi‐randomised trial; trial includes patients seeking termination of pregnancy, indication for termination unclear.
Khosravi 2017 Trial registration, includes women with termination of first trimester pregnancies for early fetal demise as well as termination on maternal indication.
Kong 2013 Trial includes also patients with incomplete miscarriage. There is 1 sentence in results section that provides success rates for only patients with silent miscarriage ("Focussing on women who were diagnosed to have silent miscarriage at recruitment, complete miscarriage rate after surgical treatment, medical evacuation and expectant management was 97.7%, 63% and 62.5%, respectively"); but when these percentages are used to calculate the number of patients with successful treatment using the number of study participants in each group (49 surgical, 46 medical and 25 expectant management; see table 1) the outcomes are impossible. So it looks like either the percentages are not right, or not all patients with missed miscarriage were analyses. Unfortunately for this group there was no specific information on missing data.
Kurshid 2010 Trial includes patients wit indication for TOP because of IUFD, congential malformations, PPROM. We tried to contact the authors for subgroup analyses on only patients with IUFD, but could not reach them.
Kyaw 2015 Conference abstract. No information on method of randomisation. Authors could not be reached for further clarification.
Linn 2015 Conference abstract. Trial includes patients with GA > 24 weeks; no subgroup analysis of only patients with GA < 24 weeks available.
Lippert 1978 Second and third trimester fetal deaths. Not obviously randomised.
Lu 2014 Article in Chinese, after translation signs of weak methodology: no exact description of dosages of medication. Furthermore no information on type of randomisation.
Lughmani 2008 Conference abstract. Unclear if time span between treatment is too short (looks like surgical evacuation is performed within 12 hours after misoprostol treatment). Authors could not be reached for further clarification.
Machtinger 2004 Abstract. Appears to include both non‐viable pregnancies and miscarriages.
Mahjabeen, 2009 Quasi‐randomised trial. Includes patients with therapeutic TOP, unclear what indication for this TOP was.
Makenzius 2017 Trial that compares miscarriage care by midwife to care by physician; other topic.
Makhlouf 2003 Not clear from paper if all pregnancies complicated by fetal death. Seeking clarification from authors.
Martin 1965 Allocation based on alternation, not randomisation. Alternation violated.
Montesinos 2011 Wrong patient population ‘incomplete abortion’.
Moran 2005 Other topic (treatment of pregnancy of unknown location).
Mostafa‐Gharebaghi 2010 Trial includes patients with termination of pregnancy because of fetal death, congenital malformations, PPROM and 'other causes'. We tried to contact the authors for subgroup analyses on only patients with fetal death, but could not reach them.
Mulayim 2009 Other subject (misoprostol after surgical treatment for miscarriage).
Naghshineh 2015 Trial included women with spontaneous miscarriage (non‐viable pregnancy) < 17 weeks as well as induced abortion. No subgroup analyses for spontaneous miscarriage only.
Nakintu 2001 Both second and third trimester fetal deaths. Seeking separate data from author.
Nasreen 2009 Conference abstract. Trial includes patients with incomplete miscarriage.
Nassar 2006 Reference is trial registration. Trial was ended prematurely because of difficulties in recruitment of patients.
NCT02141555 Reference of trial registration. According to the trial register the current recruitment status is unknown, last updated in 2014. We did not find any published results.
NCT02573051 Reference of trial registration. According to the trial register the current recruitment status is unknown, last update in October 2015. We could not find any published results.
Ng 2015 Wrong patient population‐‘incomplete abortion’.
Ngai 2001 Includes data on women with both non‐viable pregnancies and incomplete miscarriages. If these data can be separated by the researchers, these data may be included in the future.
Nguyen 2005 Other subject; treatment of incomplete abortion.
Niinimaki 2006 Trial also includes patients with incomplete miscarriage. We contacted the authors to ask for subgroup analyses on only patients with missed miscarriage and anembryonic gestation, however they did not respond.
Nor 2006 Other subject (termination of pregnancy; indication unclear), trial includes patients up to GA of 26 weeks; no subgroup analysis on patients with GA < 24 weeks.
Nuthalapaty 2005 Includes patients with induction because of congential malformations or maternal indications. 1 of the outcome measures was live birth rate (?). We tried to contact the authors for further clarification but could not reach them.
Nuutila 1997 Trial included women with fetal malformations and maternal indications for pregnancy termination between 12 and 24 weeks, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Owen 1999 Trial included women with fetal malformations and maternal indications for pregnancy termination between 16 and 24 weeks, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Paraskevaides 1992 Small study of 16 women "randomised" to surgical evacuation or prostaglandin F2alpha or Trilostane treatment. No details about clinical presentation or ultrasound and clinical findings, but from abstract includes both women with non‐viable pregnancies and incomplete miscarriage.
Paritakul 2010 Wrong patient population‐‘incomplete abortion’.
Patua 2013 Other subject, treatment of incomplete miscarriage.
Perry 1999 Excluded women with fetal deaths.
Piotrowski 1979 Not clear that this was a randomised trial.
Pongsatha 2004 Trial excluded women with fetal deaths.
Prasartsakulchai 2004 Quasi‐randomised: patients could choose for medical, surgical or expectant management. Only patients who chose medical management were further randomised. However patients did not meet inclusion criteria for the review, as they already experienced abdominal pain and vaginal bleeding, e.g. ongoing miscarriage, which is beyond the scope of this review.
Promwangkwa 2017 Participants in this study had a gestational age 14‐24 weeks. Indications for termination of pregnancy included intra uterine fetal demise, but also termination of pregnancy of live fetus for other fetal and maternal indications. No subgroup analyses were made for IUFD up to 20 weeks of gestation.
Rahimi‐Sharbaf 2015 Trial studies women with termination of pregnancy with GA 13‐24 weeks because of congenital of maternal indications. No subgroup analyses were performed for only women with IUFD.
Ramadan 2009 Conference abstract. Other subject, incomplete abortion.
Ramsey 2004 Trial included women with other reasons for pregnancy termination, as well as pregnancies with fetal death. We tried to contact the authors but could not reach them.
Reeves 2006 Other subject (endometrial thickness as predictor for further intervention); no subgroup analyses on only patients with missed abortion.
Reeves 2008 Other subject (endometrial thickness as predictor for further intervention); no subgroup analyses on only patients with missed abortion.
Rivero‐Lopez 1998 Other subject; cervical priming before intervention.
Robledo 2007 Other subject; predictive study (to identify indicators for success of misoprostol treatment).
Roy 2003 Abstract. Not clear if fetal death included as indication for termination.
Ruangchainikhom 2006 Other subject (termination of pregnancy because of obstetric reasons). Full data unavailable.
Saeed 2018 This trial meets all inclusion criteria. However data extraction was not possible. The table presenting the main results contained numbers of unknown origin. It was unclear whether percentages or number of participants were displayed. The numbers in this table did also not correspond with the main text, attributing to further doubt as to what the numbers in the table represent.
Salamalekis 1990 Abstract only. Treatment allocation by alternation, not by randomisation.
Salari 2012 Conference abstract. Other subject (other patient population); therapeutic abortion.
Shaheen 2017 In this trial women were not adequately randomised. The paper describes a quasi randomised trial with women being "divided into two groups".
Shaikh 2008 Conference abstract. No subgroup analysis on missed miscarriage.
Shelley 2005 Other subject; treatment of incomplete or ongoing miscarriage.
Shobeira 2007 Conference abstract. No article with full study results found. Authors could not be reached to ask for such an article.
Shochet 2012 Other subject (incomplete abortion).
Shokry 2009 Other subject, other intervention (reduction of bleeding after surgical evacuation).
Shuaib 2013 The type of randomisation is unclear. It seems that both groups had different types of follow up, especially for the surgically treated group it is unclear if they really all had successful outcome (for example: no information on ultrasound follow‐up). Weak methodology, high risk of bias on all fronts.
Shwekerela 2007 Other subject (reduction of bleeding after surgical evacuation).
Smith 2006a This was a qualitative study. No numeric comparison between the groups. Furthermore, study group includes women with an incomplete miscarriage; no subgroup analyses were performed for only patients with missed miscarriage.
Smith 2009 Study includes also patients with incomplete miscarriage. There was no subgroup analysis available for only patients with a non‐viable pregnancy.
Srikhao 2005 Since patients participating in this study already experienced vaginal blood loss and abdominal pain this is considered ongoing or incomplete miscarriage; therefore this study is not eligible for the review.
Sripramote 2000 Other subject; cervical priming before surgical evacuation.
Stockheim 2006 The data presented in this trial were reciprocal. It is not valid to present reciprocal data for outcomes from trials because they are not reported in the way we have specified the review. This study was therefore not included in this review.
Su 2005 Termination of pregnancy for fetal anomalies, social reasons or maternal disease; not for non‐viable pregnancies.
Suchonwanit 1999 Abstract of residents research paper. No article with full study results found; author could not be reached to ask for such an article.
Surita 1997 Abstract only. May include third trimester fetal deaths.
Tam 2005 Study investigating reproductive outcome after miscarriage treatment; patients were included in a previous trial. This previous trial was not retrieved from the search, but was identified screening the reference list of an excluded study; this trial also included patients with incomplete miscarriage. There were no subgroup analyses available for only patients with a non‐viable pregnancy.
Tanha 2013 Unclear whether all patients meet inclusion criteria for review, it seems like also patients with legal abortion or TOP because of congenital malformations were included. We tried to contact the authors for further clarification but could not reach them.
Taylor 2011 Other subject; treatment of incomplete abortion.
Thavarasah 1986 Unclear from paper but allocation may have been by alternation. We tried to contact the authors but could not reach them.
Thida 2015 Conference abstract. We searched for full study results but could not find them. We tried to contact the authors to ask if there is an article with study results published, but could not reach them.
Toppozada 1994 Includes third trimester fetal deaths.
Toptas 2011 Conference abstract. No subgroup analysis of only patients with termination because of IUFD. Authors could no be reached for further clarification.
Torre 2012 Trial also includes patients with incomplete miscarriage. We tried to contact the authors for subgroup analysis on patients with missed miscarriage, but they did not respond.
Van Mensel 2009 Trial includes patients with GA > 24 weeks. We tried to contact the authors to ask for subgroup analyses on patients with GA < 24 weeks; but they did not respond.
Yapar 1996 Includes indications for termination other than fetal death. High degree of protocol violation (60/400). Results not presented as intention‐to‐treat.
Yilmaz 2005 Other subject; termination of pregnancy because of congenital or chromosomal abnormalities.
Yilmaz 2007 Other subject; termination of pregnancy because of congenital/chromosomal abnormalities.
Zanganeh 2012 Other subject; termination of pregnancy because of fetal or maternal problems.
Zhang 2000 Seems to be a trial about cervical priming before delivery. Outcome measures irrelevant for this review.
Zhang 2005 Includes both non‐viable pregnancies and miscarriages. We tried to contact the authors to retrieve data on non‐viable pregnancies only, but we could not reach them.

GA: gestational age
 hCG: human chorionic gonadotropin
 IUFD: intrauterine fetal death
 mg: milligram
 mm: millimetre
 POC: products of conception
 PPROM: preterm premature rupture of membranes
 RCT: randomised controlled trial
 RPOC: retained products of conception
 TOP: termination of pregnancy