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Management of early pregnancy loss with mifepristone and misoprostol: Clinical predictors of treatment success from a randomized trial

American Journal of Obstetrics and Gynecology May 21, 2020

Sonalkar S, Koelper N, Creinin MD, et al. - Researchers sought the clinical predictors linked with treatment success in patients receiving medical management with mifepristone–misoprostol or misoprostol alone for early pregnancy loss. A planned secondary analysis was performed of a randomized trial comparing mifepristone–misoprostol with misoprostol alone for managing early pregnancy loss. They identified overall 297 evaluable participants for inclusion in the primary study, with 148 in the mifepristone–misoprostol combined treatment group and 149 in the misoprostol-alone treatment group. Among participants who had vaginal bleeding at the time of treatment, expulsion of pregnancy tissue occurred in 15 of 17 (88%) in the mifepristone–misoprostol combined treatment group and 12 of 17 (71%) in the misoprostol-alone treatment group. Analyses reveled no predictive value of any of the baseline clinical factors for treatment success in women receiving medical management with misoprostol for early pregnancy loss. Treatment success improved with adding mifepristone to the medical management regimen of early pregnancy loss; hence, they recommend considering mifepristone treatment for management of early pregnancy loss regardless of baseline clinical factors.

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