{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:26:57Z","timestamp":1786739217933,"version":"build-2736575974"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Misoprostol is widely used in the medical management of missed abortions. However, pretreatment with Mifepristone has shown to be effective but still not recommended to be used in missed abortions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims and Objectives:<\/jats:title>\n                    <jats:p>To compare the outcome of medically managed missed abortion or blighted ovum using combination regime (Mifepristone and Misoprostol) vs Misoprostol alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>It was a prospective single-centre study performed in the Department of Obstetrics and Gynaecology, HIMSR and HAHC hospital, New Delhi, over, for one year. All the patients with diagnosed missed abortions were randomized into two groups (Group A and Group B). Group A was given Mifepristone 200 mg orally followed by Misoprostol 800 microgram per vaginal. Group B was given Misoprostol 800 microgram per vaginal. All the patients were observed for 24 hours for the expulsion of products of conception following the given regime. Ethical approval was taken from the Institutional Ethical Committee.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Both groups were comparable in demographic characteristics. On applying Fisher\u2019s exact test, it has been observed that the odds of nonexpulsion of the product of conception, time taken in expulsion, and surgical evacuation because of excessive bleeding were significantly higher in Group B (Misoprostol) compared with Group A (Mifepristone followed by Misoprostol). The cost-effective analysis showed that the cost is higher among Misoprostol Group B compared with combination drugs of Group A (Mifepristone + Misoprostol), but this result is not significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Mifepristone can be considered before Misoprostol in missed abortions. This regime might decrease the need for surgical evacuation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jfmpc.jfmpc_503_23","type":"journal-article","created":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T16:10:46Z","timestamp":1696867846000},"page":"2423-2427","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["A prospective study on the effectiveness of a combination regime (Mifepristone and Misoprostol) in comparison with Misoprostol for missed abortion"],"prefix":"10.4103","volume":"12","author":[{"given":"Nidhi","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Science and Research, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reva","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Sitaram Bhartia Institute of Science and Research, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumedha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Science and Research, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aruna","family":"Nigam","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Science and Research, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeet","family":"Panesar","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, ABVIMS and RML Hospital, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,10,11]]},"reference":[{"key":"R1-20260203","first-page":"CD002253","article-title":"Medical treatment for early fetal death (less than 24 weeks)","volume":"6","author":"Lemmers","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"issue":"Suppl 2","key":"R2-20260203","first-page":"S182-5","article-title":"Misoprostol to treat missed abortion in the first trimester","volume":"99","author":"Gemzell-Danielsson","year":"2007","journal-title":"Int J Gynaecol Obstet"},{"key":"R4-20260203","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1136\/bmj.322.7298.1343","article-title":"Management of spontaneous miscarriage in the first trimester: An example of putting informed shared decision making into practice","volume":"322","author":"Ankum","year":"2001","journal-title":"BMJ"},{"key":"R5-20260203","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1056\/NEJM200003303421307","article-title":"Medical termination of pregnancy","volume":"342","author":"Christin-Maitre","year":"2000","journal-title":"N Engl J Med"},{"key":"R6-20260203","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1111\/j.1471-0528.2000.tb13273.x","article-title":"Comparison of two doses of Mifepristone in combination with Misoprostol for early medical abortion: A randomised trial","volume":"107","year":"2000","journal-title":"BJOG"},{"key":"R7-20260203","first-page":"1445","article-title":"Misoprostol for uterine evacuation in patients with early pregnancy failures","volume":"190","author":"Murchison","year":"2004","journal-title":"Am J Obstet Gynecol"},{"key":"R8-20260203","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1056\/NEJMoa044064","article-title":"A comparison of medical management with Misoprostol and surgical management for early pregnancy failure","volume":"353","author":"Zhang","year":"2005","journal-title":"N Engl J Med"},{"key":"R9-20260203","first-page":"1060","article-title":"Management of missed abortion: Comparison of medical treatment with Mifepristone _Misoprostol or Misoprostol alone with surgical evacuation. 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