Misoprostol Alone Versus Misoprostol Preceded by Letrozole for Time Needed for Induction of Miscarriage in Cases of Missed Miscarriage

Objective: The aim is to assess the effect of use of letrozole prior to misoprostol versus use of misoprostol only on termination time during induction of medical evacuation in cases of missed abortion.Methods: This is a randomized controlled trial including a total of 70 pregnant women diagnosed with first trimesteric missed miscarriage , divided into two groups. First group was given letrozole before start of induction with Misoprostol, second group was given misoprostol only.The rate of successful medical abortion without the need for surgical intervention was calculated as a primary outcome, with secondary outcomes including need of surgical intervention, and time needed for complete medical abortion.Results: The induction to complete abortion interval was significantly different between the two groups (6.77±2.21 in letrozole group vs. 11.72±3.18 in misoprostol group, P<0.05). Complete abortion was significantly higher in the letrozole group (71.4%) than in the misoprostol group (48.5% ), P value 0.031.Conclusion: Letrozole when added to misoprostol can increase the rate of successful medical abortion.