ArticleEClinicalMedicine2021
Mifepristone followed by misoprostol compared with placebo followed by misoprostol as medical treatment for early pregnancy loss (the Triple M trial): A double-blind placebo-controlled randomised trial.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03212352 (Mifepristone and Misoprostol Versus Misoprostol Alone for Uterine Evacuation After Early Pregnancy Failure), which is not on this map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Mifepristone and Misoprostol Versus Misoprostol Alone for Uterine Evacuation After Early Pregnancy Failure: a Randomized Double Blind Placebo-controlled Comparison (Triple M Trial)
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Methods for managing miscarriage: a network meta-analysis.The Cochrane database of systematic reviews · 2021Pooled it
- Predicting the likelihood of successful medical treatment of early pregnancy loss: development and internal validation of a clinical prediction model.Human reproduction (Oxford, England) · 2022Trial
- Trial
- Ectopic pregnancy.Nature reviews. Disease primers · 2024Review
- Management of early pregnancy loss by reproductive endocrinologists: does access to mifepristone matter?F&S reports · 2024Article
- Abortion Restrictions Threaten Miscarriage Management In The United States.Health affairs (Project Hope) · 2024Article
- Clinical factors associated with subsequent surgical intervention in women undergoing early medical termination of viable or non-viable pregnancies.Frontiers in medicine · 2024Article
- Retained Products of Conception (RPOC): Diagnosis, Complication & Management.Journal of obstetrics and gynaecology of India · 2023Review
- Failure Rate of Medical Treatment for Miscarriage Correlated with the Difference between Gestational Age According to Last Menstrual Period and Gestational Size Calculated via Ultrasound.Journal of clinical medicine · 2023Article
- Haemodynamic stability following adrenaline intracervical block for major haemorrhage during surgical management of late miscarriage: A case report.Case reports in women's health · 2023Article
- Surgical intervention after medical treatment for early pregnancy loss according to gestational size.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2023Article
- Utility and Limitations of Human Chorionic Gonadotropin Levels for Remote Follow-up After Medical Management of Early Pregnancy Loss.Obstetrics and gynecology · 2022Article
- Article
- Diagnostic criteria for retained products of conception-A scoping review.Acta obstetricia et gynecologica Scandinavica · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 12 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWorldwide, millions of women seek treatment for early pregnancy loss (EPL) annually. Medical management with misoprostol is widely used, but only effective 60% of the time. Pre-treatment with mifepristone prior to misoprostol might improve the success rate of medical management.
methodsThis was a multi-centre, double-blind, placebo-controlled randomised trial in 17 Dutch hospitals. Women with a non-viable pregnancy between 6 and 14 weeks of gestation were eligible for inclusion after at least one week of expectant management. Participants were randomised (1:1) between oral mifepristone 600 mg or an oral placebo tablet. Participants took 400 μg misoprostol orally, repeated after four hours on day two and, if necessary, day three. Primary outcome was expulsion of gestational sac and endometrial thickness <15 mm after 6-8 weeks. Analyses were done according to intention-to-treat principles. This trial is registered with ClinicalTrials.gov, NCT03212352.
findingsBetween June 28th 2018 and January 8th 2020, 175 women were randomised to mifepristone and 176 to placebo, including 344 in the intention-to-treat analysis. In the mifepristone group 136 (79•1%) of 172 participants reached complete evacuation compared to 101 (58•7%) of 172 participants in the placebo group (
interpretationPre-treatment with mifepristone prior to misoprostol was more effective than misoprostol alone in managing EPL.
fundingHealthcare Insurers Innovation Foundation, Radboud University Medical Centre, Canisius Wilhelmina Hospital.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.