International Journal of Gynecology & Obstetrics
Volume 96, Issue 3 , Pages 212-218, March 2007

Alternatives to mifepristone for early medical abortion

  • N.L. Moreno-Ruiz

      Affiliations

    • Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston MA, USA
    • Corresponding Author InformationCorresponding author. Department of Obstetrics and Gynecology, Boston University School of Medicine, 85 East Concord St, 6th Floor, Boston, MA 02118, USA. Tel.: +1 617 414 5112 (work), +1 617 459 5290 (home); fax: +1 617 414 7300.
  • ,
  • L. Borgatta

      Affiliations

    • Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston MA, USA
  • ,
  • S. Yanow

      Affiliations

    • Abortion Access Project, Cambridge MA, USA
  • ,
  • N. Kapp

      Affiliations

    • Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston MA, USA
  • ,
  • E.R. Wiebe

      Affiliations

    • Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
  • ,
  • B. Winikoff

      Affiliations

    • Gynuity Health Projects, New York, USA

Received 30 May 2006; received in revised form 17 August 2006; accepted 11 September 2006. published online 10 November 2006.

Abstract 

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%).

Conclusion

Alone or in combination with methotrexate, misoprostol is an efficacious alternative to mifepristone for the medical termination of pregnancy.

Keywords: Abortion, First trimester, Methotrexate, Misoprostol

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PII: S0020-7292(06)00446-2

doi:10.1016/j.ijgo.2006.09.009

International Journal of Gynecology & Obstetrics
Volume 96, Issue 3 , Pages 212-218, March 2007