What Is the Optimal Medical Management of Miscarriage?

Miscarriage occurs in about 20% of pregnancies and is often diagnosed with the aid of ultrasound. Treatment options are expectant management, medical management, or surgical evacuation of the uterus. To determine the optimal medical management, U.K. researchers randomized 711 women with ultrasound evidence of a nonviable pregnancy at ≤14 weeks' gestation to 200 mg oral mifepristone followed 48 hours later by 800 µg misoprostol (mife-miso group) or placebo followed 48 hours later by 800 µg misoprostol (placebo-miso group). Misoprostol was given vaginally, orally, or sublingually. The primary outcome was failure to pass the gestational sac within 7 days after randomization. If significant tissue was present on ultrasound at day 7, women could…