Early Pregnancy Loss

There are several additional studies looking at mifepristone followed by vaginal or oral misoprostol. There is now clear evidence that mifepristone combined with misoprostol appears to have higher success rates compared to misoprostol alone. Based on available evidence, adding mifepristone to misoprostol for medical management is recommended, when available. Optimal doses and routes of administration of misoprostol have not been determined by randomized trials. Patients choosing medical management of EPL should have appropriate counseling regarding expected symptoms. Expectant management has a lower cost when compared to surgical management. Mifepristone and misoprostol was found to be cost-effective when compared to misoprostol alone. Endometrial thickness after medical or expectant management is not predictive of retained products of conception and/or need for surgical evacuation. Choice of management for EPL does not affect future fertility.