The association between serum progesterone and outcome of medical management of early fetal demise: A pilot study

Abstract

The study objective was to determine the relationship between serum progesterone level and the outcome of mifepristone-misoprostol regimen for medical management of missed miscarriage up to 12 weeks. A blood sample was collected just before mifepristone administration for serum progesterone assay. After 48 h, misoprostol 800 μg was administered vaginally; further 400 μg was administered 4 h later if necessary. Treatment was classed as a success if retained tissues were expelled within 72 h (Group 1), and a failure if this did not occur (Group 2). Of 52 analysed cases, complete medical evacuation occurred within 72 h in 40 (76.9%) women (serum progesterone ranged 13–90 nmol/l). Serum progesterone between the two groups were statistically significant (p < 0.001), by Mann–Whitney test. Of the 12 patients who did not respond, nine (75%) women had serum progesterone < 10 nmol/l. We found mifepristone-misoprostol regimen is less effective in missed miscarriage when serum progesterone is < 10 nmol/l.

Keywords::

• Medical evacuation
• mifepristone
• missed miscarriage
• serum progesterone

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.