Evidence map›Paper›PMID 41659219›Full record

Trial reportSultan Qaboos University medical journal2026

Efficacy and Safety of Letrozole, Misoprostol and Their Combination in First Trimester Missed Miscarriage:

Mohamed Fikry Yousef, Mamdouh Abdelfatah Sheeba, Hany Saad Amin Mohamed, Abdelrahman Adel Abdelmonem Salama, Ahmed Hassan, Marwan Taghian, Mahmoud Mostafa Hassan Ali, Ahmed Ragab Ebrahim Ragab, Ahmed Hassan, Amira Alasmer and 1 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Sultan Qaboos University medical journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mohamed Fikry YousefObstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Mamdouh Abdelfatah SheebaObstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Hany Saad Amin MohamedObstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Abdelrahman Adel Abdelmonem SalamaDiagnostic and Interventional Radiology Department, Cairo University, Cairo, Egypt.
Ahmed HassanColumbia University Irving Medical Center, New York, USA.
Marwan TaghianOncosurgery Department, NHS Lothian, Lothian, United Kingdom.
Mahmoud Mostafa Hassan AliOncosurgery Department, 6th October Hospital for Health Insurance, Cairo, Egypt.
Ahmed Ragab Ebrahim RagabAlharam Specialized Hospital, Cairo, Egypt.
Ahmed HassanObstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Amira AlasmerObstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Mohamed Ramadan MohamedObstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: This study evaluated the efficacy and safety of misoprostol, letrozole and their combination in first trimester missed miscarriage. Methods: This single-blind, randomised controlled trial was conducted between March 2023 and August 2024 among women diagnosed with first trimester missed miscarriage at Kasr Al-Aini Hospital, Cairo, Egypt. Participants were randomly assigned to three groups: misoprostol-only (Group A), letrozole plus misoprostol (Group B) and letrozole-only (Group C). The primary outcome was the rate of complete miscarriage. Secondary outcomes included abortion timing, adverse effects, need for surgical evacuation and the effect of age, body mass index (BMI) and gestational age on success. Results: A total of 225 women were included in this study. Group B had the highest cumulative complete miscarriage rate by day 7 (76.0%) compared with Group A (53.5%) and Group C (62.5%) ( Conclusion: Combining letrozole with misoprostol significantly improves complete miscarriage rates with tolerable safety. Letrozole alone is safer but less effective. Thus, combination therapy may offer an optimal non-surgical strategy for individualised management.

Indexed as

Abortion, MissedLetrozoleMisoprostolAbortifacient Agents, NonsteroidalAdultDrug Therapy, CombinationEgyptFemaleHumansPregnancyPregnancy Trimester, FirstSingle-Blind MethodTreatment OutcomeAbortifacient Agents, NonsteroidalLetrozoleMisoprostolAbortionLetrozoleMisoprostolOman

Identifiers

PMID41659219
PMCPMC12875326

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Registered trials

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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.