A comparison of the psychologic impact and client satisfaction of surgicaltreatment with medical treatment of spontaneous abortion: A randomized controlled trial

OBJECTIVE: The purpose of this study was to compare the psychologic impact and client satisfaction of routine surgical evacuation of the uterus with m edical evacuation in cases of spontaneous abortion. STUDY DESIGN: This was a prospective, randomized controlled trial. Two hund red eighteen women who were admitted to a university teaching hospital afte r spontaneous abortion and who consented to the study were randomized to ro utine surgical evacuation or medical evacuation of the uterus with the use of misoprostol. General psychologic, well-being, level of depression, fatig ue symptoms, psychiatric morbidity, social functioning, client satisfaction , and acceptance were measured in the 2 groups. RESULTS: The 2 groups did not differ in any of the measured psychological o utcomes. Significantly more participants who experienced successful evacuat ion of the uterus with the misoprostol protocol would choose the same mode of treatment if they were able to choose again. However, participants for w hom the medical treatment failed to evacuate the uterus and subsequent surg ical evacuation was required are significantly less satisfied with the trea tment. CONCLUSION: Medical treatment of spontaneous abortion with misoprostol is p sychologically safe and more compatible with the ethnomedical beliefs of ou r Chinese participants. Client satisfaction and acceptance should be taken into consideration in the evaluation of treatment outcomes.