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Recent Advances in the Medical Management of Early Pregnancy Loss

  • Family Planning (A Burke, Section Editor)
  • Published:
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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.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Pennsylvania, 3400 Spruce Street, 1000 Courtyard, Philadelphia, PA, 19104, USA

    Jade M. Shorter, Courtney A. Schreiber & Sarita Sonalkar

Authors
  1. Jade M. Shorter
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  2. Courtney A. Schreiber
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  3. Sarita Sonalkar
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Corresponding author

Correspondence to Jade M. Shorter.

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Conflict of Interest

CAS is a consultant for Danco Laboratories, LLC. The Department of Obstetrics and Gynecology, University of Pennsylvania, receives contraceptive research funding from the NIH, the Society of Family Planning, Bayer, Daré, FHI360, Medicines360, and Sebela. In addition, Dr. Schreiber has a patent 62/777,369 pending.

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Shorter, J.M., Schreiber, C.A. & Sonalkar, S. Recent Advances in the Medical Management of Early Pregnancy Loss. Curr Obstet Gynecol Rep 9, 60–65 (2020). https://doi.org/10.1007/s13669-020-00282-0

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