title: A randomized prospective study of misoprostol or mifepristone followed by misoprostol when needed for the treatment of women with early pregnancy failure.
abstract: OBJECTIVE
  To compare the effectiveness and safety of misoprostol and mifepristone, followed when needed by misoprostol, for the treatment of women with early pregnancy failure.
  
  
  METHODS
  Prospective randomized nonblinded controlled trial.
  
  
  METHODS
  University-affiliated tertiary medical center.
  
  
  METHODS
  One hundred fifteen consecutive women diagnosed as having a blighted ovum or missed abortion of <9 weeks of gestation enrolled.
  
  
  METHODS
  The patients received orally 600 mg mifepristone (group I) or orally 800 microg misoprostol (group II). Most patients in both groups subsequently received 48 hours later orally 800 microg misoprostol.
  
  
  METHODS
  Failure was defined as surgical intervention due to retained gestational sac 48 hours after completion of the drug protocol, severe symptoms, or suspected retained products of conception after the menstrual period.
  
  
  RESULTS
  The success rate was similar in groups I and II: 38 of 58 patients (65.5%) versus 42 of 57 patients (73.6%), respectively. No cases of severe infection or bleeding necessitating blood transfusion occurred.
  
  
  CONCLUSIONS
  Misoprostol is an effective and safe treatment for early pregnancy failure and could replace surgical curettage in over two-thirds of the patients. Mifepristone offers no advantage compared with misoprostol as initial treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel. stockheim@013.net.il
authors.forename: David
authors.initials: D
authors.lastname: Stockheim
authors.forename: Ronit
authors.initials: R
authors.lastname: Machtinger
authors.forename: Amir
authors.initials: A
authors.lastname: Wiser
authors.forename: Mordechai
authors.initials: M
authors.lastname: Dulitzky
authors.forename: David
authors.initials: D
authors.lastname: Soriano
authors.forename: Mordechai
authors.initials: M
authors.lastname: Goldenberg
authors.forename: Eyal
authors.initials: E
authors.lastname: Schiff
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Seidman
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000028:Abortion, Induced / Q000379:methods*; D000030:Abortion, Missed / Q000188:drug therapy*; D000328:Adult; D004338:Drug Combinations; D005260:Female; D006727:Hormone Antagonists / Q000008:administration & dosage; D006801:Humans; D015735:Mifepristone / Q000008:administration & dosage* / Q000009:adverse effects; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D011256:Pregnancy Outcome; D016896:Treatment Outcome
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D004338:Drug Combinations; D006727:Hormone Antagonists; D016595:Misoprostol; D015735:Mifepristone