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Objective. —To compare the safety and efficacy of early abortion by administration of methotrexate and misoprostol vs administration of misoprostol alone. Design. —Randomized controlled trial. Setting. —San Francisco (Calif) General Hospital. Patients. —Pregnant women at 56 days' gestation or less seeking elective abortion. Sixty-three women volunteered for the trial; 61 completed the study and are included in the analysis. Intervention. —Intramuscular administration of 50 mg of methotrexate per square meter of body surface area followed 3 days later by vaginal administration of 800 μg of misoprostol (group 1) or the same dose of misoprostol given alone (group 2). The misoprostol dose was repeated 24 hours later if abortion had not occurred. Main Outcome Measures. —Successful abortion, duration of vaginal bleeding, side effects, and change in β—human chorionic gonadotropin β-hCG) level. An abortion was considered successful if the pregnancy ended without requiring a surgical procedure. Results. —Complete abortion occurred in 28 (90%) of 31 patients in group 1 and 14 (47%) of 30 patients in group 2 (PConclusions. —Methotrexate and vaginal misoprostol are more effective than misoprostol alone. Both drugs are available throughout the United States, and both drugs are inexpensive. This combination may offer an alternative to the use of antiprogestin and prostaglandin for medical abortion. (JAMA. 1994;272:1190-1195)
Mitchell D. Creinin (Wed,) studied this question.