Comparing abortion induced with methotrexate and misoprostol to methotrexate alone

This was a dual-cohort study performed to determine if, by using methotrexa te alone, abortions could be induced with fewer side effects, without sacri ficing effectiveness and patient satisfaction. The subjects were 358 consec utive patients who requested elective medical termination of pregnancy at < 7 weeks gestation. Women were given information and allowed to choose betwe en methotrexate alone (50 mg/m(2) intramuscularly) or methotrexate followed 4 days later by 800 mu g misoprostol vaginally. The two groups were compar ed with respect to the number of surgical aspirations required, the number of days until the abortion was completed, side effects, and the number of w omen who would choose the same method again. The surgery rate for methotrex ate was 17.2%, whereas for the combination it was 10.9%. The mean numbers o f days until the abortion were complete was 23 and 12, respectively. Side e ffects, mean pain scores, total days of bleeding, and satisfaction Fates we re not significantly different in the two groups. The high failure rate wit h methotrexate alone suggests that it should not be offered despite the hig h level of satisfaction. (C) 1999 Elsevier Science Inc. All rights reserved .