Alternatives to mifepristone for early medical abortion.
OBJECTIVE
To review published reports of first-trimester medical abortion regimens that do not include mifepristone.


METHODS
Reports listed in Pubmed and Medline on prospective and controlled trials of the efficacy of misoprostol, alone or associated with methotrexate, for first-trimester abortion were analyzed if they included more than 100 participants and were published since 1990.


RESULTS
The efficacy of regimens using misoprostol alone ranged from 84% to 96%, and when misoprostol was used with methotrexate the efficacy ranged from 70% to 97%. Efficacy rates were influenced by follow-up interval. Treatment for infection, bleeding, and incomplete abortion were infrequent with both methods (0.3%-5%).


CONCLUSIONS
Alone or in combination with methotrexate, misoprostol is an efficacious alternative to mifepristone for the medical termination of pregnancy.
Moreno-Ruiz
N L
NL
Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA 02118, USA. Nilda.Moreno@bmc.org
Borgatta
L
L
Yanow
S
S
Kapp
N
N
Wiebe
E R
ER
Winikoff
B
B
D000021:Abortifacient Agents, Steroidal; D000028:Abortion, Induced / Q000379:methods*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage*; D015735:Mifepristone / Q000008:administration & dosage*; D011247:Pregnancy; D011261:Pregnancy Trimester, First
D000021:Abortifacient Agents, Steroidal; D015735:Mifepristone; D008727:Methotrexate