Medical abortion: decisions, decisions. (FYI).

Two medical abortion regimens, one using methotrexate followed by misoprostol and the other using mifepristone followed by misoprostol, had generally similar profiles with respect to effectiveness, side effects, complications and acceptability in a multicenter, controlled trial. (1) Roughly 500 women were assigned to each regimen, and in both groups, about 95% had a successful abortion without surgical intervention. The major difference in outcomes was that the abortion occurred more quickly for those using mifepristone than for those who took methotrexate (three vs. seven days, on average). Complication rates were similar for the two groups, as were the overall proportions who had side effects after taking either of the study drugs or the misoprostol. However, women using methotrexate were more likely than those in the mifepnstone group to have fever, chills or diarrhea after taking the misoprostol; they also rated the worst of the pain slightly higher (6.3 vs. 5.8 on a scale of 0-10). The vast majority of both groups said that they would choose their method again, although the proportion was significantly higher among women who took mifepristone (88%) than among those who used methotrexate (83%).

(1.) Wiebe E et al., Comparison of abortions induced by methotrexate or mifepristone followed by misoprostol, Obstetrics & Gynecology, 2002, 99(5, pt. 1):813-819.