Effect of misoprostol with and without letrozole on the induction of abortion for women with first‐trimester missed abortion

Allameh, Zahra; Goharian, Maryam; Eslamian, Mohammad

doi:10.1002/ijgo.13326

Cited by 13 publications

(10 citation statements)

References 24 publications

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“…Clearance is the main treatment for MA, but the death of the embryo absorbs a large amount of amniotic fluid causing organization of the tissue, and the necrotic tissues may form a tight connection with the uterine wall and cannot be completely detached from the uterine wall, which can lead to difficulty in scraping or hemorrhage after the scraping procedure [ 3 ]. If the pregnancy tissue remains in the uterine cavity for a longer period of time, it can also lead to tissue lysis and release of large amounts of hemolysin into the blood circulation of the pregnant woman, causing a coagulation disorder, which can cause massive uterine bleeding and even lead to diffuse intravascular coagulation [ 4 ]. Therefore, the use of medications or other treatments to promote the release of mechanized placental tissue from the uterine wall prior to cleansing surgery becomes crucial in the treatment of MA.…”

Section: Introductionmentioning

confidence: 99%

Clinical Efficacy and Safety Study of Mifepristone with Misoprostol Treatment in Patients with Missed Abortion

Zhao¹,

Zhang

Lou³

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Currently, medication abortion is widely used in clinical practice in China. The aim of this study was to investigate the effect of mifepristone with misoprostol treatment on the efficacy of patients with missed abortion (MA) and the safety of this drug regimen. 95 patients with MA treated in our hospital from February 2019 to April 2021 were collected as the subjects of this study, and the patients were divided into the control and the research groups according to different treatment modalities. Among them, 46 cases in the control group were treated by diethylstilbestrol combined with oxytocin and 49 cases in the research group were treated by mifepristone combined with misoprostol, and both groups underwent curettage after medication. The rates of complete abortion, time of embryo expulsion, time of operation, intraoperative bleeding, time of postoperative vaginal bleeding, amount of vaginal bleeding, rate of one-time curettage, the levels of serum estradiol (E2), progesterone (P), β-chorionic gonadotropin (β-hCG), and interleukin-18 (IL-18), and the incidence of adverse effects in the two groups were examined and compared. Alanine transaminase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), and serum creatinine (Scr) were used as indicators to evaluate the safety of the drug. The results showed that the rates of complete abortion and one-time curettage were significantly higher in the study group than in the control group, while the time of embryo expulsion, operation time, intraoperative bleeding, postoperative vaginal bleeding time, and vaginal bleeding were significantly lower than in the control group. The serum E2, P, and β-hCG levels before curettage in both groups were significantly higher, and IL-18 levels were significantly lower than those at the time of admission, with E2, P, and β-hCG levels increasing more and IL-18 levels decreasing more in the research group. After drug treatment, no abnormal changes in liver and kidney functions were observed in both groups, and the incidence of adverse reactions was at a similar and lower level in both groups. This shows that mifepristone with misoprostol is a safer and more effective drug regimen for the treatment of MA, which can regulate the levels of serum sex hormones and inflammatory factors in the body, promote the shedding of placental tissue, and create conditions for improving the rate of curettage.

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Section: Introductionmentioning

confidence: 99%

Clinical Efficacy and Safety Study of Mifepristone with Misoprostol Treatment in Patients with Missed Abortion

Zhao¹,

Zhang

Lou³

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…(21). Also, in the study of Allameh et al, there was no significant relationship between the group receiving Miso and the group receiving Miso + letrozole (11).…”

Section: Discussionmentioning

confidence: 86%

“…It has been shown that in recent years, medical methods have been mostly used for abortions because this method is safer and more acceptable than surgical methods (8,9). One of the medical and medicinal approaches involves the use of prostaglandins, both alone and in combination with other medications (10,11). Miso is an analog of prostaglandin E1, which is prescribed for the prevention and treatment of gastric and duodenal ulcers (12,13).…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effect of Vaginal Misoprostol with and Without Laminaria on Ripening or Cervical Preparation in the Second Trimester Abortion: A Randomized Clinical Trial Study

Behnoud

Noori

Ghasemi

et al. 2022

Zahedan J Res Med Sci

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Background: Therapeutic abortion in the second trimester of pregnancy is the treatment of choice in cases such as severe anomalies or fetal death, and both medical and mechanical methods are used to prepare the cervix. One of the various medical methods is the use of misoprostol (Miso) and one of the various mechanical methods is the use of laminaria (Lam). Objectives: This study aimed to compare the use of Miso alone and its combination with Lam in therapeutic abortion in the second trimester of pregnancy. Methods: In this clinical trial study, pregnant women between 14 and 20 weeks of gestation who were admitted to Ali-Ibn Abitaleb Hospital in Zahedan from July 2019 to September 2020 and were candidates for pregnancy termination due to severe anomalies or fetal death were investigated. After obtaining consent, patients were randomly divided into two groups of 45 receiving Miso alone and Miso + Lam. Then, in addition to demographic variables, the number of hospitalization days, the need for curettage, blood transfusions, analgesics, and the symptoms and complications of drugs were investigated. Results: In this study, none of the demographic factors were significantly different between the two groups (P > 0.05). However, the need for curettage (P = 0.05), labor time (P = 0.04), and hospitalization days (P = 0.003) in the Miso + Lam group were less than the group of Miso alone. Conclusions: Our results showed that curettage cases, labor duration, and length of hospital stay decreased in the Miso + Lam group.

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“…They reported rates of complete abortion of 80% and 51.8%, respectively, and an induction duration of 6.1 ± 1.6 and 9.4 ± 2.2 hours, respectively (P<0.05). Another study reported that the rate of complete abortion was 93.7% in the group taking 10 mg of letrozole daily for 3 days followed by 600 μg of oral misoprostol and 68.7% in the misoprostol only group [10] .…”

Section: A Comparative Study Between Methotrexate Versus Letrozole Pr...mentioning

confidence: 99%

“…By this drug, estrogen synthesis block leads to increase endogenous gonadotropin and finally stimulates growth of ovarian follicles, and also this drug could play a role in abortion therapy via inhibiting estrogen synthesis . This drug is also used to breast cancer related to estrogen [10] . Short time use of letrozole in inducing miscarriage had no severe consequences and its usual side effects are sweating, arthralgia, and fatigue, but could decrease bleeding resulted from medical miscarriage [11] .…”

Section: A Comparative Study Between Methotrexate Versus Letrozole Pr...mentioning

confidence: 99%

A Comparative Study between Methotrexate versus Letrozole Prior to Misoprostol in Induction of First Trimester Missed Miscarriage

Bahaa

Ahmed²,

Amen³

et al. 2022

Minia Journal of Medical Research

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Background: Miscarriage is the loss of a pregnancy before the period of viability. In the better resourced parts of the world, fetuses weighing 500 g or more or a gestational age above 24 weeks can survive although they may be handicapped. A missed miscariage is a nonviable intrauterine pregnancy that has been retained within the uterus without spontaneous abortion. Aim is to compare the synergistic effect of methotrexate versus letrozole before misoprostol for induction of first trimester missed miscarriage. Method: The study was conducted at Minia University Hospital and Eledwa General Hospital in the period from February 2021 to February 2022. The study included 199 women randomly allocated into two groups: Group (A): 99 women received letrozole (2.5 mg×3 tablets/day) + misoprostol (200 μg)/8h for 3 days], and Group (B): 100 women received [methotrexate (50 mg) im+ misoprostol (200 μg)/8h for 3 days]. Result: Both letroazole and methotrexate are effective in increasing the efficiency of misoprostol in inducing first trimester missed with a better side effects profile in the letrozole group. Conclusion: Letrozole administration prior to misorostol can be a safe and effective treatment in inducing first trimester missed miscarriage.

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Effect of misoprostol with and without letrozole on the induction of abortion for women with first‐trimester missed abortion

Cited by 13 publications

References 24 publications

Clinical Efficacy and Safety Study of Mifepristone with Misoprostol Treatment in Patients with Missed Abortion

Clinical Efficacy and Safety Study of Mifepristone with Misoprostol Treatment in Patients with Missed Abortion

Comparison of the Effect of Vaginal Misoprostol with and Without Laminaria on Ripening or Cervical Preparation in the Second Trimester Abortion: A Randomized Clinical Trial Study

A Comparative Study between Methotrexate versus Letrozole Prior to Misoprostol in Induction of First Trimester Missed Miscarriage

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