Methotrexate and misoprostol for early abortion: A multicenter trial. Acceptability

A prospective trial was conducted including 300 pregnant women seeking elective abortion to evaluate the efficacy and acceptability of methotrexate and misoprostol for abortion at ≤56 days gestation. Subjects received methotrexate 50 mg/m² intramuscularly followed 7 days later by misoprostoI 800 μg vaginally. The misoprostol dose was repeated the next day if the abortion did not occur. Efficacy is reported elsewhere. Subjects were questioned before the study as to their reasons for choosing a medical abortion and past experience with surgical abortion. After the study was completed, the women were questioned about their medical abortion experience. All questions were asked in an open-ended manner. Main outcome measures included reasons for abortion and study participation, attitudes about the nonsurgical abortion experience, and feelings about preference of nonsurgical or surgical abortion. The most common reason cited as to why women chose to have a nonsurgical abortion was to avoid some aspect of the surgery (48.4%). The percent of women who cited that avoiding surgery was an important reason in their choice of nonsurgical abortion varied by study site and according to whether the woman had a prior surgical abortion. Upon completion of the study, 73.4% of women stated it was a good experience, 19.5% a neutral experience, 7.1% a bad experience, and 1.0% gave no response. When asked what method they would choose if they had to have another abortion, 83.5% would choose this method of medical abortion rather than a surgical abortion. Intramuscular methotrexate and vaginal misoprostol are an acceptable and desirable method of abortion.