[Embryo expulsion induction in first trimester miscarriages. Use of mifepristone (RU 486) in a double blind...

We investigated the use of oral mifepristone (RU486) for the induction of natural expulsion in women with spontaneously interrupted pregnancy in the first trimester in a double blind placebo controlled study against placebo. 46 women consulting for interrupted pregnancy diagnosed at ultrasound with no clinical sign of miscarriage were included in the trial. Main outcome measures were occurrence of natural expulsion, frequency of complete expulsion need for subsequent surgical evacuation, analgesia and need for transfusion. Natural expulsion occurred within 5 days in 82% patients receiving treatment versus 8% placebo treated patients (p < 0.001). All patients experienced bleeding after RU486 and 2 needed emergency aspiration for haemorrhagic expulsion. The treatment failed in 4 patients who underwent evacuation under local anesthesia. In the control group 19 patients underwent evacuation under local (n = 9) or general (n = 11) anesthesia.

A standard oral pilot dose of 600 mg of Mifepristone induces natural expulsion in 82% women with non developing first trimester intra-uterine pregnancies.