A Survey on Traditional Chinese Medicine as an Adjunct to Conventional Medical Abortion (Mifepristone and Misoprostol) and Its Potential Influence on Relevant Outcomes or Complications

Background: The incidence of early missed abortion (MA) has risen significantly, reaching 15%. Conventional medical abortion using mifepristone and misoprostol, while effective, often leads to complications such as incomplete abortion and excessive bleeding. Traditional Chinese medicine (TCM), including Xinshenghua granule and Fujiu No.2, offers a potential alternative by promoting uterine contraction and reducing complications. Objectives: This study aimed to evaluate the efficacy of combining TCM with standard medical abortion for MA. Methods: A retrospective analysis was conducted on 218 MA patients admitted to the Department of Obstetrics and Gynecology at Ningbo Women and Children's Hospital (December 2018 - December 2022). Eligibility criteria included: (1) The MA confirmation via transvaginal ultrasound (no embryonic cardiac activity, gestational sac consistent with MA); (2) 6 - 16 weeks of gestation; (3) no prior tocolytic use; (4) no history of adverse pregnancy outcomes/familial genetic diseases; (5) voluntary medical abortion with informed consent. Patients were divided into an observation group (n = 108: Mifepristone+misoprostol+Xinshenghua granule+Fujiu No.2 acupoint application) and a control group (n = 110: Mifepristone+misoprostol only). Outcomes included pregnancy tissue expulsion time, vaginal bleeding volume and duration, hospitalization duration, and serum β-human chorionic gonadotropin (β-HCG) levels. Statistical analyses were performed using SPSS version 27. Results: The observation group showed significant improvements over the control group in key metrics: Sorter menstrual interruption time (9.824 ± 1.766 vs. 23.559 ± 30.056 days, P < 0.001), reduced vaginal bleeding duration (7.632 ± 1.767 vs. 8.728 ± 1.975 days, P < 0.001), lower vaginal bleeding volume (63.52 ± 12.889 vs. 72.8 ± 19.250 mL, P < 0.001), and faster pregnancy tissue expulsion (44.510 ± 10.402 vs. 52.077 ± 12.915 h, P < 0.001). Hospitalization duration was also shorter in the observation group (4.340 ± 1.185 vs. 4.950 ± 1.426 days, P < 0.001). Serum β-HCG levels improved more significantly in the observation group (P < 0.05). Conclusions: The combination of Xinshenghua granule and Fujiu No.2 with standard medical abortion significantly enhances the management of MA by reducing vaginal bleeding, accelerating tissue expulsion, and improving hormonal recovery. This TCM-based approach offers a safer and more effective alternative to conventional treatments.