The effect of mifepristone pretreatment during medical manag
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The study says that mifepristone pretreatment reduces the severity of pain but not bleeding during medical management of early pregnancy loss.

The study published in the journal Contraception was carried out to compare participant-reported bleeding and pain with two medication regimens for early pregnancy loss (EPL).

Researchers performed a secondary analysis of a randomized trial in which participants took either mifepristone 200 mg orally followed by misoprostol 800 mcg vaginally 24 hours later or misoprostol alone for medical management of EPL. Participants reported bleeding and pain (Numeric Pain Rating Scale, NPRS, 0-10) with daily paper diaries and at study visits on trial days 3, 8, and 30. 143 participants received mifepristone pretreatment.

The findings were:
--A larger proportion of this group reported moderate or heavy bleeding on trial day 2, the day of misoprostol administration, compared with those who did not receive pretreatment.

--Between days 4 and 8, more mifepristone-pretreatment participants reported mild or no bleeding, compared with the misoprostol-only arm.

--The average pain score for trial days 2-4 was higher for the pretreatment group compared with the misoprostol-only group, and there was a trend toward a shorter total duration of pain. These differences remained after controlling for treatment success across arms.

Conclusively, mifepristone pretreatment increased the severity of pain but not bleeding and resulted in a shorter trajectory of symptoms during medical management of EPL.

Source: https://doi.org/10.1016/j.contraception.2021.04.023
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