This breakthrough could reduce the need for miscarriage surgery and increase the chance of completion of miscarriage management. A combination of Mifepristone and misoprostol has been found to be more effective in treating missed miscarriage. This research comes at a time when access to surgery is limited and so having a treatment that results in a higher rate of completion of missed miscarriage gives more choice to women[1].
Women with PCOS are at increased risk of miscarriage due to high androgens which can adversely affect the endometrium [2]. A missed miscarriage or silent miscarriage is when the baby dies in the womb but this is not discovered until later, but usually during the first 14 weeks of gestation. In the case of a missed miscarriage all the foetal tissue is still in the womb, unlike an incomplete miscarriage where some of the tissue is expelled by the uterus.
Missed miscarriage management usually involves one of 3 options. Some women prefer to wait and see if the miscarriage completes naturally while others opt for medical or surgical intervention to speed up the process. Occasionally however, misoprostol fails to sufficiently stimulate the uterus which leads to the woman having to have surgery anyway. By combining misoprostol with Mifepristone, this study found that it leads to a higher rate of completion by 7 days compared to treatment with misoprostol alone[1].
The study authors argue this combination treatment should be considered as first-line treatment for medical management of missed miscarriage [1]. Of course, as with all treatments it is important to consider the safety, risks and side effects which need to be discussed with your medical team to discover what is right for you but most will agree this is a great breakthrough.
For further information, advice and support you can contact:
Miscarriage Association
Tommy’s
REFERENCES
[1] J.J. Chu, A.J. Devall, L.E. Beeson, P. Hardy, V. Cheed, Y. Sun, T.E. Roberts, O. Ogwulu, E. Williams, L.L. Jones, J.H. La, F. Papadopoulos, R. Bender-Atik, J. Brewin, K. Hinshaw, M. Choudhary, A. Ahmed, J. Naftalin, N. Nunes, A. Oliver, F. Izzat, K. Bhatia, I. Hassan, Y. Jeve, J. Hamilton, S. Deb, C. Bottomley, J. Ross, L. Watkins, M. Underwood, Y. Cheong, C.S. Kumar, P. Gupta, R. Small, S. Pringle, F. Hodge, A. Shahid, I.D. Gallos, A.W. Horne, S. Quenby, A. Coomarasamy, Articles Mifepristone and misoprostol versus misoprostol alone for the management of missed miscarriage (MifeMiso): a randomised, double-blind, placebo-controlled trial, (2020). https://doi.org/10.1016/S0140-6736(20)31788-8.
[2] M. Bahri Khomami, A.E. Joham, J.A. Boyle, T. Piltonen, M. Silagy, C. Arora, M.L. Misso, H.J. Teede, L.J. Moran, Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression, Obes. Rev. 20 (2019) 659–674. https://doi.org/10.1111/obr.12829.
© PCOS Vitality, 2020. PCOS Vitality does not recommend a particular course of action and does not provide medical advice or promote any products or drugs. For information purposes only.
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