Comparative Study between the Effect of Letrozole Prior to Misoprostol and Misoprostol Alone in Cases of Missed Abortion

Background: Missed abortion is characterized as presence of dead products of conception inside the uterus. Incidence: once the fetus is dead, spontaneous abortion occurs in 80% of women within 2 weeks and only 10% remain undelivered for more than 3 weeks, interestingly found evidence of delayed spontaneous labor when fetal death was due to Rh-isoimmunization, 50% of mothers remaining undelivered after 5 weeks. Aim of the Work: To assess the impact of letrozole combined with misoprostol on induction of abortion compared with usage of misoprostol alone. Patients and Methods: This was comparative study that was performed on 150 women diagnosed as missed abortion at Al-Hussein University Hospital February 2021. All patients were randomly dividing into 2 groups: Group A: 75 women (were induction of abortion by letrozole 7.5 mg (Femara) once daily for 3 days, followed by misoprostol 400mcg vaginally every 4h up to maximum five doses per day). Group B: 75 women (were induction of abortion by misoprostol (misotac) 400mcg vaginally every 4h up to five doses per day). Results and conclusion: In instances with first-trimester miscarriages, a three days courses of letrozoles (7.5 mg per day) followed by misoprostols (400 mg) was associated with significantly greater complete abortion rates (81.3% vs. 53.3%); however, prescribing letrozoles before misoprostol was successful in improving the effectiveness of misoprostol for provoking abortion without increasing adverse reactions. Finding the ideal treatment plan to accomplish the greatest proportion of effectiveness and the lowest number of side-effects may require doing more, larger studies over longer durations and using a variety of doses