- Adding mifepristone (Mifeprex) to misoprostol (Cytotec) improves success rate for medical treatment of first-trimester miscarriage.
Why this matters
- Early pregnancy loss is common and is often treated with active medical management.
- Using mifepristone plus misoprostol improves the success of medical management of miscarriage without increasing side effects.
- Treatment success occurred in 83.8% (95% CI, 76.8-89.3) in the combination groups vs 67.1% (95% CI, 59.0-74.6) is the misoprostol-alone group.
- Taking misoprostol
- No differences in reported side effects, including blood transfusion and pelvic infection, between groups.
- Randomized trial.
- Women with a nonviable pregnancy between 5 and 12 completed weeks of gestation were randomly assigned to receive pretreatment with 200 mg of mifepristone orally followed by 800 μg of misoprostol vaginally after 24 hours (n=148) vs misoprostol alone (n=149).
- The primary outcome was gestational sac expulsion by the first follow-up visit (24 hours to 4 days after misoprostol use).
- Success assessed by transvaginal ultrasound.
- Funding: The National Institute of Child Health and Human Development of the National Institutes of Health; Women’s Reproductive Health Research award.
- No placebo group.