The Value of Pretreatment With Letrozole on Induction Time of Medical Evacuation With Misoprostol in Cases of Missed Abortion

Inclusion Criteria: * Women aged 18 - 45 years. * Diagnosed with missed abortion confirmed by ultrasound (absent fetal heartbeat and/or no embryonic development). * Gestational age ≤ 12 weeks based on last menstrual period * Hemoglobin levels \>10 g/dL. * BMI ranging from 25 to 35 kg/m2. * Hemodynamically stable and no signs of infection. Exclusion Criteria: * Incomplete abortion, inevitable abortion, or threatened miscarriage. * Suspected ectopic pregnancy and molar pregnancy. * History of allergy or contraindication to misoprostol or letrozole. * Coagulopathy or use of anticoagulant medications. * Chronic medical diseases (e.g., uncontrolled diabetes, cardiovascular disease, liver or renal dysfunction). * Prior uterine surgery that contraindicates medical abortion (e.g., classical cesarean section, myomectomy with uterine entry). * Uterine anomalies. * Women unsure of LMP