A recent study published in the Maternal-Fetal Medicine Journal found that terminated bleeding after 2 weeks is a predictive indicator for effective medical induction of early pregnancy loss (EPL).

This prospective observational cohort study by Simon-Hermann Enzelsberger et al. was performed with an intent to improve counselling of women by reporting bleeding characteristics at home following the medical management of an EPL with mifepristone and misoprostol and to assess the bleeding patterns as a predictive tool.

A total of 197 women who presented with an EPL were enrolled. They chose mifepristone 200 mg and misoprostol 800 mcg for home-based medical management. Starting with the intake of mifepristone, a diary was maintained by the patient where vaginal bleeding was noted daily for 14 days. Treatment success was defined as no earlier recognized retained products of conception (RPOC) in 3 months. Finally, 154 women were included in the analysis keeping in view all drop-out criteria.

The occurrence of bleeding was reported by 40.0% of patients amid mifepristone and misoprostol intake. The median span of vaginal bleeding including spotting was 13 days. The likelihood of RPOC was around 6 times in the group of persistent bleeding than terminated bleeding group after 2 weeks. A possible link between elevated serum levels of leukocytes at treatment beginning with RPOC was revealed.