A Prospective Double-Blind, Randomized, Placebo-Controlled Trial on the Use of Letrozole Pretreatment with Misoprostol for Second-Trimester Medical Abortion

Abstract

Second trimester abortion constitutes 9.7-11.2 of all abortions in the united states and the united kingdom. The recommended regiment is 200 mg mifepristone followed 36-48 hours later by 800 mcg vaginal misoprostol. In countries where mifepristone is not available, misoprostol only regimen could be used. In the current study, A prospective double-blind, randomized, controlled clinical trial was carried out on 400 pregnant women attending casualties, obstetric clinic and fetal care unit of Ain Shams University Maternity Hospital during the period from January 2015 and August 2016. This study was carried out To compare the success rate of letrozole and misoprostol versus misoprostol alone for medical termination of pregnancy in second trimester abortion. Patients fulfilling inclusion criteria were divided into two groups, each one will be 200 patients to avoid the drop in the size of the study, half of them received letrozole and the other half received placebo to insure that everyone has the chance of participation, randomization will be guided by computer generated list Induction of abortion was carried according to (FIGO 2012) protocol of induction, 200 mcg misoprostol per vagina every 6hours with maximum four doses (if gestational age between 12-17wks) and 100 mcg misoprostol per vagina every 6hours with maximum four doses (if gestational age between 18-24wks). In our study, Comparison between the two groups as regards the incidence of unwanted outcomes and complications of misoprostol revealed No significant difference between both of them. The results of the current study showed that among letrozole group, the oxytocin need for augmentation of abortion and surgical evacuation decreased, while completed medical abortion increased.