Methotrexate and misoprostol for abortion at 57-63 days gestation.
Methotrexate and misoprostol have been shown in preliminary studies to be effective for abortion at < or = 56 days gestation with minimal side effects. RU-486 is used in combination with prostaglandin for abortion < or = 49 days gestation in France but < or = 63 days gestation in England. This pilot study was performed to evaluate if methotrexate and misoprsotol may also be effective up to 63 days gestation. Ten pregnant women between 57-63 days gestation were treated with methotrexate 50 mg/m2 intramuscularly followed 3 days later by misoprostol 800 micrograms vaginally. Abortion occurred in 6 women; abortion occurred in one of the women after a repeat dose of misoprostol 24 hours after the first dose. The remaining 4 women all had a surgical abortion. In the successfully treated women, vaginal bleeding lasted 14 +/- 4 (mean +/- standard deviation) days and serum beta-hCG was < or = 25 IU/L by 32 +/- 5 days after the methotrexate injection. No methotrexate side effects occurred. Methotrexate and misoprostol do not appear to be as effective for medical abortion between 57 and 63 days gestation as compared to < or = 56 days gestation.
Creinin
M D
MD
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco General Hospital.
D000028:Abortion, Induced / Q000379:methods*; D000082:Acetaminophen / Q000627:therapeutic use; D000284:Administration, Oral; D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D003061:Codeine / Q000627:therapeutic use; D003085:Colic / Q000139:chemically induced / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D007273:Injections, Intramuscular; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects / Q000592:standards*; D015735:Mifepristone / Q000008:administration & dosage / Q000009:adverse effects / Q000592:standards; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects / Q000592:standards*; D010865:Pilot Projects; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000187:drug effects; D013997:Time Factors
D006063:Chorionic Gonadotropin; D016595:Misoprostol; D015735:Mifepristone; D000082:Acetaminophen; D003061:Codeine; D007052:Ibuprofen; D008727:Methotrexate