METHOTREXATE AND MISOPROSTOL FOR ABORTION AT 57-63 DAYS GESTATION

Methotrexate and misoprostol have been shown in preliminary studies to be effective for abortion at less than or equal to 56 days gestation with minimal side effects. RU-486 is used in combination with prostaglandin for abortion less than or equal to 49 days gestation in France but less than or equal to 63 days gestation in England. This pilot study was performed to evaluate if methotrexate and misoprsotol may also be effective up to 63 days gestation. Ten pregnant women between 57-63 days gestation were treated with methotrexate 50 mg/m(2) intramuscularly followed 3 days later by misoprostol 800 mu g vaginally. Abortion occurred in 6 women; abortion occurred in one of the women after a repeat dose of misoprostol 24 hours after the first dose. The remaining 4 women all had a surgical abortion. in the successfully treated women, vaginal bleeding lasted 14 +/- 4 (mean +/- standard deviation) days and serum beta-hCG was less than or equal to 25 IU/L by 32 +/- 5 days after the methotrexate injection. No methotrexate side effects occurred. Methotrexate and misoprostol do not appear to be as effective for medical abortion between 57 and 63 days gestation as compared to less than or equal to 56 days gestation.