Letrozole Pretreatment with Misoprostol Versus Misoprostol Alone For Induction of First Trimesteric Missed Miscarriage A Randomized Controlled Trial

Abstract

Missed miscarriage is defined as retention of dead products of conception inside the uterus. (Cunningham et al., 2001). It occurs in up to 15% of all clinically recognized pregnancies. (Torre et al., 2012). Each year, more than forty million abortions are occurred all over the world. (Sedgh et al., 2007). Missed miscarriages in the first trimester are characterized by the arrest of embryonic or fetal development with ultrasound findings of an empty gestational sac or an embryo/fetus without cardiac activity. (Danielson et al., 2007). The cervix is closed and there is no or only slight bleeding. (Silver 2010). Expectance, surgery or medication is usually referred. Surgical interventions are effective and may lead to a complete abortion, but such procedures may be risky. (Kapp et al., 2010). Over the past decade, medical termination of pregnancy in the first trimester gained popularity with the highly effective regimen combining mifepristone and misoprostol. (Lee et al., 2011)c.