A Comparison of Medical Management with Misoprostol and Surgical Management for Early Pregnancy Failure

This randomized trial found that vaginal misoprostol was a safe, effective, and acceptable alternative to surgical evacuation for early pregnancy failure. In the misoprostol group, 71% had complete expulsion by day 3 and 84% by day 8, while treatment failure by day 30 was 16% with misoprostol versus 3% with surgery, with serious complications like hemorrhage or infection being rare in both groups. The authors concluded that 800 micrograms of vaginal misoprostol is a reasonable nonsurgical option, especially because most patients said they would use it again or recommend it.