Letrozole and misoprostol are increasingly used for the medical management of first-trimester missed miscarriage, although the optimal regimen remains uncertain. While misoprostol alone is commonly prescribed, combining it with other agents such as letrozole may improve success rates. To address this uncertainty, a study evaluated the efficacy and safety of misoprostol alone, letrozole alone and letrozole plus misoprostol in 225 women with first-trimester missed miscarriage.
The study found that the letrozole plus misoprostol regimen achieved the highest cumulative complete miscarriage rate by day 7 (76.0%) compared with misoprostol alone (53.5%) and letrozole alone (62.5%), with earlier abortion by day 4 also most frequent in the combination group (68.4%). Although combination therapy was associated with higher rates of bleeding (85.3%) and pain (92.0%), severe adverse events were…
