ORAL METHOTREXATE AND VAGINAL MISOPROSTOL FOR EARLY ABORTION

Intramuscular methotrexate followed by vaginal misoprostol has been sh own to be effective for abortion at less than or equal to 49 days gest ation. Oral dosing of the methotrexate may offer advantages over paren teral dosing. This pilot study was performed to evaluate if oral metho trexate would be effective when combined with vaginal misoprostol to e fject abortion at less than or equal to 49 days gestation. Twenty preg nant women were randomized to receive methotrexate 25 mg or 50 mg foll owed 7 days later by misoprostol 800 mu g vaginally. The misoprostol d ose was repeated the next day ii the abortion did not occur. Complete abortion occurred in all subjects in both groups within 20 days alter the methotrexate. However, women in the 50 mg group passed the pregnan cy within 24 hours of the first or second dose of methotrexate more of ten than women in the 25 mg group (80% vs. 50%, p = 0.35). Vaginal ble eding lasted 12.2 +/- 3.1 days and 9.4 +/- 4.5 days in immediate succe ss and delayed success patients, respectively. Oral methotrexate may b e an effective alternative to intramuscular methotrexate in treatment regimens for non-surgical abortion.