Recent Advances in the Medical Management of Early Pregnancy Loss

Abstract

Purpose of Review: To provide an update on advances in medical management of early pregnancy loss, including the addition of mifepristone pretreatment to existing regimens. Recent Findings: The utilization of misoprostol for medical management of early pregnancy loss has been studied extensively and is established as a safe and effective treatment. Two recent randomized controlled trials have demonstrated that the addition of mifepristone pretreatment significantly increases the effectiveness of misoprostol and a large body of data demonstrate the excellent safety profile of mifepristone. However, the Food and Drug Administration Risk Evaluation and Mitigation Strategy restrictions impose a major barrier to mifepristone use. Summary: The addition of mifepristone to existing misoprostol regimens has significantly improved the effectiveness and patient-centered benefits of medical management of early pregnancy loss. Mifepristone restrictions need to be removed in order to decrease the barriers to women obtaining evidence-based care.