Sequential use of mifepristone and misoprostol in treatment of early pregnancy failure appears more effective than misoprostol alone: a retrospective study

Eur J Obstet Gynecol Reprod Biol. 2014 Dec:183:16-9. doi: 10.1016/j.ejogrb.2014.10.010. Epub 2014 Oct 14.

Abstract

Objective: Is treatment of early pregnancy failure (EPF) with sequential use of mifepristone and misoprostol more effective than treatment with misoprostol alone?

Study design: In a retrospective cohort study at the Department of Obstetrics and Gynaecology of the Radboud University Medical Centre, 301 women with early pregnancy failure receiving medical treatment between January 2008 and March 2013 were included. Of these, 199 women were pre-treated with 200mg mifepristone (orally) followed by 2 consecutive doses of 800mcg misoprostol (vaginally) and 102 women were treated with 2 consecutive doses of 800mcg misoprostol (vaginally) alone.

Results: Complete expulsion was achieved in 66.8% of the women treated with a sequential combination of mifepristone and misoprostol versus 54.9% of the women treated with misoprostol alone. The difference in rates of complete expulsion was 11.9% (P<0.05; 95% CI 0.3-23.6%).

Conclusions: Medical treatment of early pregnancy failure with a sequential combination of mifepristone and misoprostol was more effective than treatment with misoprostol alone. Our findings will have to be confirmed by a large prospective multicentre double blinded-randomized trial.

Keywords: Early pregnancy failure; Mifepristone; Misoprostol.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortifacient Agents, Nonsteroidal / administration & dosage*
  • Abortifacient Agents, Nonsteroidal / therapeutic use
  • Abortifacient Agents, Steroidal / administration & dosage*
  • Abortifacient Agents, Steroidal / therapeutic use
  • Abortion, Spontaneous / drug therapy*
  • Administration, Intravaginal
  • Administration, Oral
  • Adult
  • Cohort Studies
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Humans
  • Mifepristone / administration & dosage*
  • Mifepristone / therapeutic use
  • Misoprostol / administration & dosage*
  • Misoprostol / therapeutic use
  • Pregnancy
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Abortifacient Agents, Nonsteroidal
  • Abortifacient Agents, Steroidal
  • Misoprostol
  • Mifepristone