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Non-Surgical Abortion

Non-Surgical Abortion Using Mifeprex

Candidates for non-surgical abortion using Mifeprex (RU486) must be less than eight weeks pregnant (56 days from last menstrual cycle). A non-surgical abortion is usually complete within 24 to 72 hours, but will require at least one follow up visit and repeat vaginal ultrasound.

The following information will help you to decide if a non-surgical abortion using Mifeprex is the best choice for you.

In September of 2000 the FDA approved the drug Mifeprex (RU486) to be used in terminating early pregnancies. Mifeprex taken orally used in conjunction with Misoprostol causes the embryo to be "sloughed off" by the lining of the uterus.

This procedure has been proven approximately 96% effective.

There is no evidence that using Mifeprex will affect a woman's ability to get pregnant in the future, but once ingested the abortion procedure must be completed, because the drugs can cause serious birth defects.

What is Mifeprex?

Mifeprex is the only FDA approved non-surgical option for ending early pregnancy. Mifeprex blocks progesterone, a naturally produced hormone that prepares the lining of the uterus for a fertilized egg and helps maintain the pregnancy. Without progesterone, the lining of the uterus softens, breaks down and bleeding begins.

Misoprostol, a prostaglandin that causes the uterus to contract, follows Mifeprex. This medication helps to complete the process.

What are the advantages of taking Mifeprex?

Mifeprex is a noninvasive option for ending early pregnancy. This medication is taken orally, avoiding surgery or anesthesia in most cases. Vaginal ultrasound has made it possible to detect an early pregnancy and now with Mifeprex women can take immediate action.

Is an early abortion using Mifeprex safe?

The risks of having an early non-surgical abortion are fewer than with childbirth, but even with the most careful medical care before, during, and after the procedure, there is always a chance of unknown problems or complications.

What are the side effects of Mifeprex?

Bleeding and cramping are a normal part of the process. Women may experience pain that is similar to or greater than a heavy period and you can expect bleeding or cramping for approximately 7 to 14 days. In some cases women have experienced heavy bleeding and need to contact their doctors office right away. Other side effects include nausea, headache, vomiting, and diarrhea. A pain reliever can be prescribed to help alleviate discomfort.

Please call our office if you would like to schedule an appointment or have any further questions regarding Mifeprex or non-surgical abortion procedures.

916-446-0222 / 800-954-2464

Non-Surgical Abortion Using Methotrexate

Candidates for non-surgical abortion using Methotrexate must be less than six weeks pregnant by ultrasound. A non-surgical abortion is usually complete within 6-7 days, but may take up to thirty-five days to complete and may require up to five office visits.

Please read the information below to help you decide if non-surgical abortion is right for you.

Our office has over 10 years experience using Methotrexate for early non-surgical abortions. This drug was used extensively for medical abortions prior to Mifeprex (RU486). It is not as effective as the Mifeprex (RU486) at inducing abortion, but is valuable when an ectopic pregnancy is suspected.

What is Methotrexate and what is its history?

Methotrexate is a folic acid antagonist and has been available in the United States since 1953 when the Food and Drug Administration approved it for treatment of certain forms of cancer. It is also used in lower doses to treat various forms of autoimmune diseases, such as arthritis and psoriasis.

In addition, since 1982, many physicians have begun to use Methotrexate as a treatment for ectopic pregnancy. Used in selected patients for this purpose, it has been shown to have a 94 percent success rate in treating early ectopic pregnancy.

Follow-up studies of these patients have shown that they are able to conceive again at rates at least as good as those of women whose ectopic pregnancies are treated surgically.

How does Methotrexate work for early abortion?

Methotrexate can cause an early abortion by blocking the folic acid from fetal cells so that they cannot divide. It may also affect attachment of the embryo to the uterine wall. In research to date, Methotrexate has been administered in combination with misoprostol, a prostaglandin that causes uterine contractions, which expel the embryo.

The combination has been used in women up to about a month after a missed menstrual period. In clinical studies, women have received an intramuscularly injection of 50 milligrams of Methotrexate per square meter of body surface area, followed two to seven days later by 800 micrograms of misoprostol administered vaginally.

The bleeding associated with the procedure is typically equal to that of an early, spontaneous miscarriage and may continue for up to four weeks. Side effects include prolonged bleeding and spotting, cramping, nausea, and diarrhea.

Because Methotrexate is known to damage rapidly dividing cells, it may pose a risk to a developing embryo if the pregnancy is carried to term after exposure. In a small minority of cases, women who have been treated with Methotrexate for abortion do not expel the embryo. Those women may need to return to a health care provider to complete the abortion surgically.

What is known about the safety of Methotrexate?

The use of Methotrexate for other indications provides us with a wealth of information about its long- and short-term effects. The dose and method of application for use of Methotrexate for non-surgical abortion is very similar to its use for treatment of ectopic pregnancies, and there is substantial documentation of its safety for that use.

It is especially important to note that the future fertility of women who are treated with Methotrexate for ectopic pregnancies does not seem to be impaired. Women given higher doses of Methotrexate for cancer treatment in the 1950s and 60s have given birth to healthy children who have developed normally. One study of cancer patients reported an increased risk of leukemia 20 years after treatment with a group of 25 different drugs, one of which was Methotrexate. No study of patients treated only with Methotrexate has shown an increased risk of cancer.

How is Methotrexate different from Mifepristone (RU 486)?

There is much less experience using Methotrexate for abortion than there is with Mifepristone, and we do not yet have all the facts necessary to do a full comparison of the two drugs. Even at this early stage, however, some differences between the two are clear:

  • Mifepristone is an anti-progestin, which works by blocking the hormone progesterone, which is necessary to sustain an early pregnancy. Methotrexate is a folic acid antagonist, which creates a folic acid deficiency that prevents development of the embryo. It may also affect the attachment of the embryo to the uterine wall.
  • Methotrexate works on both ectopic and intrauterine pregnancies, while Mifepristone may only be effective in aborting an intrauterine pregnancy.
  • Over 100,000 women in Europe have used Mifepristone --which is also used safely in combination with misoprostol. Methotrexate has been studied in far fewer women.
  • Experience suggests that Methotrexate may not be as effective as Mifepristone and that the abortion process takes longer with Methotrexate.

Please call our office if you would like to schedule an appointment or have any further questions regarding Methotrexate or non-surgical abortion procedures. 916-446-0222 / 800-954-2464

For additional information about Medical Abortion with Methotrexate, CLICK HERE.

5301 F Street, Suite 10 • Sacramento, CA 95819   Phone: (916) 446-0222 or (800) 954-2464