Effect of letrozole plus misoprostol in terminating nonviable first-trimester pregnancies

Background The abortion rate is roughly 15–20%, and it is the most common complication of early pregnancy in humans. Over the past decade, medical termination of pregnancy in the first-trimester gained popularity with the highly effective regimen combining mifepristone and misoprostol. Objective The aim of this study is to evaluate the effect of letrozole plus misoprostol to terminate nonviable pregnancies in first-trimester compared with the use of misoprostol alone. Patients and methods This was a single-blind randomized controlled study conducted at Itay El-Baroud General Hospital, where 90 pregnant women diagnosed as missed abortions were approached and divided into two groups. Group A included 45 women who received letrozole 10 mg daily for 3 days before receiving 600 μg misoprostol orally. Group B included 45 women who received four tablets of placebo for 3 days before receiving 600 μg of oral misoprostol. Results There were significant differences between the two groups, with better outcomes found for the letrozole group in terms of complete abortion rate, decreased rate of surgical intervention, and decreased major adverse effects compared with misoprostol alone. Conclusion The use of 10 mg daily for 3 days of oral letrozole combined with 600 μg of oral misoprostol in missed abortion can significantly the increase rate of complete abortion, decrease surgical intervention, decrease blood loss, decrease the time to induce abortion, and decrease the major adverse effects when compared with misoprostol alone.