Sushil Kumar1, Z K Antony2, A Kapur2, M Togra3. 1. Senior Adviser (Obstetrics & Gynaecology), INHS Asvini, Mumbai. 2. Classified Specialist(Obstetrics & Gynaecology), INHS Asvini, Mumbai. 3. Medical Officer, INHS Sanjivani, Kochi.
Abstract
BACKGROUND: The objective of this study was to confirm the effectiveness and safety of methotrexate and misoprostol or misoprostol alone for abortion up to 12 weeks of gestation. METHODS: A group of volunteer patients desiring MTP with gestations up to 84 days (12 weeks) were studied. The patients were divided into 2 groups. Group 1 patients with gestation up to 56 days were further subdivided as (a) Patients who received methotrexate 50 mg IM + misoprostol 800 gms intravaginal and (b) patients who only received 800 gms of misoprostol. Group 2 included the patients who were 8-12 weeks pregnant and they received same treatment as group 1 (b). Outcome measures assessed included successful abortion (complete abortion without need for surgery), side effects, decrease in hemoglobin and mean duration of vaginal bleeding. RESULTS:Complete abortion occurred in 36 (90%) of 40 patients in group 1 (a), 10 (67%) of 15 patients in group 1(b) and 29 (83%) of 35 patients in group 2. There were only 2 patients with clinically significant decrease in hemoglobin, but none required transfusions. Vaginal bleeding lasted 15 ± 6 days in group 1 (a), 16 ± 6 days in group 1(b) and 16 ± 5 days in group 2. All the patients stopped bleeding when endometrial thickness was < 5mm. Five percent women had stomatitis after methotrexate and 44% patients had fever with chills after misoprostol administration. CONCLUSION: Considering the low cost and availability of methotrexate and misoprostol, these drugs constitute a good alternative for medical abortion. They are safe and effective.
RCT Entities:
BACKGROUND: The objective of this study was to confirm the effectiveness and safety of methotrexate and misoprostol or misoprostol alone for abortion up to 12 weeks of gestation. METHODS: A group of volunteer patients desiring MTP with gestations up to 84 days (12 weeks) were studied. The patients were divided into 2 groups. Group 1 patients with gestation up to 56 days were further subdivided as (a) Patients who received methotrexate 50 mg IM + misoprostol 800 gms intravaginal and (b) patients who only received 800 gms of misoprostol. Group 2 included the patients who were 8-12 weeks pregnant and they received same treatment as group 1 (b). Outcome measures assessed included successful abortion (complete abortion without need for surgery), side effects, decrease in hemoglobin and mean duration of vaginal bleeding. RESULTS: Complete abortion occurred in 36 (90%) of 40 patients in group 1 (a), 10 (67%) of 15 patients in group 1(b) and 29 (83%) of 35 patients in group 2. There were only 2 patients with clinically significant decrease in hemoglobin, but none required transfusions. Vaginal bleeding lasted 15 ± 6 days in group 1 (a), 16 ± 6 days in group 1(b) and 16 ± 5 days in group 2. All the patients stopped bleeding when endometrial thickness was < 5mm. Five percent women had stomatitis after methotrexate and 44% patients had fever with chills after misoprostol administration. CONCLUSION: Considering the low cost and availability of methotrexate and misoprostol, these drugs constitute a good alternative for medical abortion. They are safe and effective.
Authors: Premila W Ashok; Avril Kidd; Gillian M M Flett; Ann Fitzmaurice; Wendy Graham; Allan Templeton Journal: Hum Reprod Date: 2002-01 Impact factor: 6.918
Authors: B Winikoff; I Sivin; K J Coyaji; E Cabezas; B Xiao; S Gu; M K Du; U R Krishna; A Eschen; C Ellertson Journal: Am J Obstet Gynecol Date: 1997-02 Impact factor: 8.661
Authors: C H Gonzalez; M J Marques-Dias; C A Kim; S M Sugayama; J A Da Paz; S M Huson; L B Holmes Journal: Lancet Date: 1998-05-30 Impact factor: 79.321