Misoprostol With or Without Letrozole in Treatment of Missed Miscarriage

Study at Zagazig General Hospital

Aim of study Compare the success rate of misoprostol with versus without letrozole as a pretreatment for medical termination of pregnancy during the first trimester.

Hypothesis:

Letrozole value as a pre-treatment medication for misoprostol in induction of abortion during the first trimester.

Research question:

Will letrozole- misoprostol protocol give better results than misoprostol- alone protocol in induction of abortion during the first trimester?

Aim of the Work

Compare the success rate of misoprostol with versus without letrozole as a pretreatment for medical termination of pregnancy during the first trimester.

Hypothesis:

Letrozole value as a pre-treatment medication for misoprostol in induction of abortion during the first trimester.

Research question:

Will letrozole- misoprostol protocol give better results than misoprostol- alone protocol in induction of abortion during the first trimester?

Primary outcome:

Complete abortion (complete expulsion of products of conception with no need for curettage) within one week from the first dose of misoprostol.

Secondary outcome:

• Curettage (surgical evacuation of the products of conception)

• Incomplete abortion (retained products of conception).
• Considerable bleeding that necessitates immediate evacuation.

Inclusion Criteria:

• Woman age more than 18 years old (age of legal consent).
• BMI ranges between 25 kg/m2 and 35 kg/m2.
• Gestational age of 63 days' gestation (or less).
• Missed abortion.
• Hemoglobin leve

Exclusion criteria:

• Woman age less than 18 years old.
• BMI less than 25 kg/m2 or more than 35 kg/m2.
• Gestational age more than 63 days' gestation.
• Molar pregnancy.
• Hemoglobin level less than 10 gm/dL.
• Fibroid uterus.
• Uterus with congenital anomalies.
• Previous attempts for induction of abortion in the current pregnancy.
• Coagulation defect i.e. coagulopathy.
• Contraindication for induction of abortion e.g. heart failure.
• Allergy to misoprostol or letrozole.