Mifepristone and misoprostol for the treatment of early pregnancy failure: a pilot clinical trial

Abstract

Background In an attempt to improve efficacy for women who desire medical management of early pregnancy failure (EPF), we studied the efficacy and acceptability of mifepristone 200 mg, orally (po), followed 24 h later by misoprostol 800 μg, vaginally (pv), for the treatment of EPF. Methods We enrolled 30 women with EPF in this pilot clinical trial. All women used misoprostol 800 μg, pv, 24 h after ingesting 200 mg mifepristone. Follow-up evaluations with transvaginal ultrasonography occurred at 24 h and 1 week after treatment. Participants were offered a repeat dose of misoprostol if the pregnancy had not been expelled at the first follow-up. Results The expulsion rate with one dose of misoprostol was 90% (95% CI=79–100%). The overall success rate of the treatment was 93% (95% CI=84–100%). Conclusion This regimen of mifepristone followed by vaginal misoprostol appears to be an efficacious and acceptable treatment for EPF and may have improved results over a single dose of misoprostol alone.