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Management following spontaneous first-trimester miscarriage involves expectant, medical, or surgical treatment. Which method is associated with the highest subsequent pregnancy rate is unclear. Researchers randomized 1199 women (mean age, 31) in England who experienced first-trimester (<13 weeks' gestation) index miscarriages between 1997 and 2001 to surgical evacuation, medical treatment (mifepristone, misoprostol, or both), or expectant management. From 2005 to 2007, follow-up questionnaires were sent to participants and their physicians about miscarriage management methods and subsequent pregnancies and live births.
Having experienced a previous miscarriage predicted lower fertility: 85% of women with no prior miscarriages delivered live…