Mifepristone and misoprostol versus misoprostol alone for the management of missed miscarriage (MifeMiso): a randomised, double-blind, placebo-controlled trial

RCT reports mifepristone plus misoprostol was more effective than misoprostol alone; 59/348 (17%) in mifepristone+misoprostol group did not pass gestational sac spontaneously within 7 days vs 82/348 (24%) in placebo+misoprostol group (risk ratio 0.73, 95% CI 0.54–0.99; p=0.043).

SPS commentary:

The authors’ of a related commentary state the results of this study should lead to a change in practice in the UK and worldwide; and suggest these high-quality data provide evidence that mifepristone pre-treatment is the optimal medical approach to women with missed miscarriage. They note that the authors updated a Cochrane meta-analysis with their new data and showed a clear and statistical benefit of mifepristone pretreatment compared with misoprostol alone (RR 1·15, 95% CI 1·01–1·30).


The Lancet

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