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Purpose To evaluate the cost‐effectiveness of a strategy based on direct‐acting uterine curettage (UC) versus a pre‐direct‐acting misoprostol (1600 mg) in patients with missed abortion (MA), from the perspective of a National Health System. Methods: An open prospective cohort study was carried out at Reina Sofía University Hospital (Córdoba, Spain) from January 1, 2019 to December 31, 2019 in 180 patients diagnosed with MA. The patients chose medical treatment with intravaginal misoprostol (800 μg/4 h) or UC after receiving complete and detailed information. The effectiveness, clinical characteristics of the patients, costs of treating and managing the disease, and satisfaction with the procedures were recorded. Results: One hundred and forty‐five patients (80.6%) chose misoprostol versus 35 patients (19.4%) who chose UC. The effectiveness of misoprostol has been 42% evaluated at 48 h; UC success rate has been 100%. The incidence of side effects is significantly higher in patients treated with misoprostol (p < 0.05); as well as the number of care received by the patient (p < 0.05). Satisfaction is higher in patients treated with UC (p < 0.05). However, the cost is almost 5‐folds higher in patients treated with UC (p < 0.05). Conclusion: UC has a higher success rate, greater satisfaction, and a lower incidence of side effects, although significantly increases the cost compared to misoprostol in MA. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to compare vaginal misoprostol with the Cook cervical ripening balloon (CCRB) for induction of labor in late-term nulliparous women. Methods This open, quasi-experimental, prospective study included 109 nulliparous women with late-term pregnancies and Bishop scores < 7. Fifty-five women were allocated to receive vaginal misoprostol 25 mcg and 54 received the CCRB to induce labor. The primary outcome was the time until delivery. Secondary outcomes included time to the onset of labor and obstetric and perinatal outcomes. Results Women in the misoprostol group experienced shorter time until delivery (25.41 h vs 31.26 h; P < 0.01) and in a greater percentage gave birth within the first 24 h. Time to active stage of labor was 19.5 h and 23.8 h ( P < 0.01) for misoprostol and the CCRB, respectively. There were no differences in the rates of cesarean section or post-partum anemia. Additionally, there were no differences in rates of tachysystolia, intrapartum fever, or meconium. Perinatal outcomes, post-partum pH, Apgar scores, and neonatal admissions were similar in the two groups. Conclusion Misoprostol 25 mcg reduces labor induction time compared with the CCRB with similar safety in late-term pregnancies. [ABSTRACT FROM AUTHOR]