Alternatives to Mifepristone for Early Medical Abortion

Int J Gynaecol Obstet; 2007 Mar; 96(3):212-8; doi:10.1016/j.ijgo.2006.09.009

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.