Please select the eligibility criteria that correspond to the clinical trial below.
Title: Misoprostol Versus Expectant Management in Women With Incomplete First-trimester Miscarriage After Misoprostol Treatment: A Randomized Clinical Trial
Brief Summary: Miscarriage is defined as the spontaneous loss of a pregnancy before 24 weeks' gestation, that is, before the fetal viability. The clinical signs of miscarriage are usually vaginal bleeding associated abdominal pain and cramping . The miscarriage is named 'complete' or 'incomplete' according to whether or not tissues are retained in the uterus. If a woman has minimal bleeding but her cervix is closed, this is known as a 'threatened miscarriage. However; if the pregnancy is still inside the uterus but the cervix is open, this is described as an 'inevitable miscarriage', which it will not usually be possible to save the fetus.

From many years, the surgical curettage ('evacuation of the uterus') was considered the 'gold standard management' for miscarriage to remove the retained placental tissue. It is quickly performed and removed almost all the retained products of conception. However, the routine surgical evacuation of the uterus associated with higher rate of morbidity and mortality and should be limited for special indications.

Many studies compared the effectiveness of medical treatment compared to surgery in management of incomplete abortion. There is only one study compared the curettage with expectant management in those women after medical therapy.However; none of them, looked at the effectiveness of the second chance of medical treatment in management of incomplete abortion in trial to avoid the surgical intervention after failure of previous medical treatment. So we think that the immediate evacuation using surgical intervention is truly unnecessary in most cases of failed medical abortion and the patients may get benefit from another trial of medical treatment.


Options:
A: Inclusion Criteria:

* Patients admitted for elective first trimester abortion (termination of pregnancy/ missed abortion) at Wolfson Medical Center, gestational age \<13+0 weeks
* Written consent supplied

Exclusion Criteria:

* Contraindications to prostaglandin treatment (severe asthma, glaucoma, severe cardiac disease, renal failure)
* Prostaglandin allergy
* Genital infection
* Space-occupying lesion in the endocervical canal
* Prior cervical surgery
B: Inclusion Criteria:

1. Women with confirmed incomplete induced miscarriage, less than 12 weeks' gestation.
2. No known allergy to misoprostol.
3. Women who will be haemodynamically stable.
4. Good access to emergency facilities. Exclusion

1. Women with signs of severe infection ( fever \> 38°) 2. Women with severe vaginal bleeding 3. Women known to have allergy to prostaglandins 4. Severe abdominal pain requiring immediate intervention
C: Inclusion Criteria:

1. Gestational age 15-23 weeks by ultrasound.
2. Willing and able to sign an informed consent.
3. Placement of cervical dilators. Dilators must be placed before giving any subject doxycycline in order to ensure that all subjects who receive doxycycline will have an abortion.
4. Willing to comply with the study protocol.
5. Age at enrollment of 18 years or more.

Exclusion Criteria:

1. Need for an urgent D \& E. Indications for this include ruptured membranes, advanced cervical dilation, infection, and fetal demise.
2. Allergy to doxycycline or any tetracycline
3. Exposure to or treatment for gonorrhea or chlamydia within the past 90 days.
4. Current or recent (within the past week) use of any other antibiotic.
5. Prior cardiac valve surgery or cardiac valve replacement. These patients should all receive alternative antibiotics for endocarditis prophylaxis.
6. Active use of alcohol, heroin, or cocaine. Active use of alcohol will be defined as more than 2 drinks per day. Any use of heroin or cocaine will be considered exclusionary.
D: Inclusion Criteria:

* Bleeding
* Contractions during pregnancy

Exclusion Criteria:

* Known allergy to misoprostol
* Uterine size more than 12 weeks of gestation
* Suspected ectopic pregnancy
* Unstable hemodynamic status and chock
* Signs of pelvic infection and/or sepsis

Answer: B