Use of Letrozole Pretreatment with Misoprostol for Induction of Abortion In First-Trimester Missed Miscarriage: A Randomized Controlled Clinical Trial

Abstract

Miscarriage is the most common complication of pregnancy, occurring in 10-20% of clinically recognized pregnancies (Bagratee et al., 2004). Estrogen is important in the maintenance of pregnancy. Aromatase inhibitors such as letrozole, suppress the peripheral conversion of androgen to estrogen, the use of letrozole combined with vaginal misoprostol was more effective than misoprostol alone in termination of pregnancy up to nine weeks’ gestation(Yeung et al., 2012). Letrozole 7.5mg given daily for two days and then followed by 800 microgram of vaginal misoprostol induce complete abortion in 80% of patients(Kallner, 2012). This clinical trial was conducted at Ain Shams University Maternity Hospital in the period between April 2018 and September 2018.