Medical management of non-viable early first trimester pregnancy.
OBJECTIVE
To compare the efficacy of intramuscular methotrexate plus vaginal misoprostol to vaginal misoprostol alone in completing abortion in women with non-viable early first trimester pregnancy.


METHODS
Twenty-one women with non-viable pregnancy up to 49 days gestation were randomized to receive intramuscular methotrexate, followed 2 days later by vaginal misoprostol or misoprostol alone. We also collected patient satisfaction information.


RESULTS
Complete abortion occurred in all 12 (100%) women in the combined group and eight of nine (89%, RR = 1.13, CI 0.89-1.42) women in the misoprostol only group. Of the women, 75% rated their experience as good and would choose medical management again.


CONCLUSIONS
Either methotrexate plus misoprostol or misoprostol alone effectively completed abortion in women with non-viable early pregnancy and represent acceptable medical alternatives to surgery or expectant management.
Autry
A
A
Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, USA. mautry@mcw.edu
Jacobson
G
G
Sandhu
R
R
Isbill
K
K
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D000027:Abortion, Incomplete / Q000188:drug therapy*; D000282:Administration, Intravaginal; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D016595:Misoprostol / Q000008:administration & dosage / Q000627:therapeutic use*; D010865:Pilot Projects; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D016896:Treatment Outcome
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol; D008727:Methotrexate