Comparison between Letrozole and Mifepristone as pre-treatment in medical management of early pregnancy termination: a prospective open-label randomized controlled trial.

Miscarriage is a common early pregnancy complication that occurs in 15% to 20% of all clinical pregnancies, and the majority occur in the first trimester. According to FIGO guideline, the typical dosage of misoprostol for the medical management of first trimester miscarriage is 800 microgram vaginally or 600 microgram sublingually 3 hours apart for 2 doses. Misoprostol is a synthetic analogue of naturally occurring prostaglandin E1 which induces abortion by stimulating the myometrium and cause cervical ripening and dilatation. Misoprostol has also been used in conjunction with other medications such as Mifepristone to boost success rates up to 95%. Mifepristone in low dose, 200 mg single per oral dose, works by antagonizing progesterone hormone which is the main hormone for pregnancy continuation. Letrozole is an oral aromatase inhibitor that can prevent the production of estrogen. It has been found to be effective in the medical termination of pregnancy when coupled with misoprostol. After extensive literature search, very few studies could be found which has compared the efficacy of letrozole v/s mifepristone as pretreatment for medical management of early trimester of pregnancy termination as well no such studies could be found from this part of country. Considering the above fact, the present study has been planned to compare the efficacy between Letrozole pretreatment and Mifepristone pre treatment following Misoprostol in early termination of pregnancy for complete evacuation in medical method.

Till now I have recruited 40 cases.