Mifepristone and misoprostol for early pregnancy failure: A cohort analysis

Objective: We sought to examine outcomes of mifepristone and misoprostol for early pregnancy failure (EPF) treatment in a nonresearch setting. Study Design: A protocol was developed for physicians to use mifepristone 200 mg orally and misoprostol 800 μg vaginally for EPF. Success rates were analyzed and an adjusted multivariable regression was used to identify factors predictive of success. Results: Treatment success occurred in 99 (80%; 95% confidence interval, 7287%) of 123 patients after mifepristone and a single dose of misoprostol and 102 (83%; 95% confidence interval, 7589%) patients overall. The odds of successful medical treatment were increased in women with a diagnosis of intrauterine embryonic/fetal demise (odds ratio, 3.80) and decreased in women who made additional emergency department visits (odds ratio, 0.12). Conclusion: Patients and clinicians may be more likely to intervene surgically with an EPF when a strict study protocol is not being followed.