From the Research
The recommended dose of mifepristone for managing a blighted ovum is 200 mg, taken orally, followed 24-48 hours later by 800 mcg of misoprostol administered vaginally, buccally, or sublingually. This combination has been shown to be highly effective and safe, with a success rate of over 95% in inducing abortion in women with gestations up to 9-10 weeks 1. The use of mifepristone and misoprostol in combination has been found to be more effective than using either medication alone, and is a viable alternative to surgical management (D&C) for patients with a blighted ovum.
The evidence suggests that the 200 mg dose of mifepristone is as effective as higher doses, and is better tolerated by patients 2. The addition of misoprostol 24-48 hours after mifepristone administration increases the effectiveness of the regimen, and reduces the need for surgical intervention 3.
Some key points to consider when using this regimen include:
- Patients should expect bleeding and cramping, especially after the misoprostol dose
- Pain medication such as ibuprofen is recommended for managing discomfort
- A follow-up appointment 1-2 weeks after treatment is essential to confirm complete expulsion of tissue
- This approach is effective for gestations up to 9-10 weeks
Overall, the combination of mifepristone and misoprostol is a safe and effective option for managing a blighted ovum, and can be used as an alternative to surgical management in many cases 1.