{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T07:00:10Z","timestamp":1773298810590,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2007,4,11]],"date-time":"2007-04-11T00:00:00Z","timestamp":1176249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2007,5]]},"abstract":"<jats:p><jats:bold>Objective\u2002<\/jats:bold> The objective of this study was to compare efficacy for four medical abortion regimens used in one clinic setting: (1) misoprostol alone, (2) oral methotrexate + buccal misoprostol, (3) oral methotrexate + vaginal misoprostol, and (4) intramuscular methotrexate + vaginal misoprostol.<\/jats:p><jats:p><jats:bold>Design\u2002<\/jats:bold> Retrospective analysis of data from clinical records.<\/jats:p><jats:p><jats:bold>Setting\u2002<\/jats:bold> An anonymous women\u2019s health centre in Latin America, providing medical abortion services since 2001 in a highly restrictive setting.<\/jats:p><jats:p><jats:bold>Population\u2002<\/jats:bold> A total of 8678 women with gestations &lt;56 days, who sought a medical abortion between April 2002 and December 2004.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Chi\u2010square test was performed to compare patient characteristics by abortion outcome (success\/failure). The impact of selected variables on method success was explored through logistic regression. A second regression analysis was conducted with a subsample (<jats:italic>n<\/jats:italic>= 4022), for which data on parity and previous abortion(s) were available.<\/jats:p><jats:p><jats:bold>Main outcome measure\u2002<\/jats:bold> Abortion outcome (success\/failure) at 2\u2010week follow up.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Success rates for the three methotrexate regimens ranged from 81.7 to 83.5% and did not differ significantly; misoprostol\u2010alone regimen had a success rate of 76.8%. Efficacy was significantly higher for the three combined methotrexate regimens compared with misoprostol alone and remained so in the multivariate model (OR = 1.35). In the final regression, lower gestational age, being nulliparous, and having no previous abortions were positively correlated with method success.<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> In this real\u2010use setting, methotrexate appears to confer a significant advantage over misoprostol alone for early medical abortion. This finding is important for settings where mifepristone remains unavailable. Additional factors such as gestational age limits and patient preference should be considered in regimen selection.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2007.01274.x","type":"journal-article","created":{"date-parts":[[2007,4,26]],"date-time":"2007-04-26T07:38:52Z","timestamp":1177573132000},"page":"555-562","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Does methotrexate confer a significant advantage over misoprostol alone for early medical abortion? A retrospective analysis of 8678 abortions"],"prefix":"10.1111","volume":"114","author":[{"given":"T","family":"Aldrich","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Winikoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,4,11]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000152003.94320.59"},{"key":"e_1_2_7_3_2","unstructured":"Alan Guttmacher Institute.Women Families and the Future. New York NY:AGI 1994."},{"key":"e_1_2_7_4_2","unstructured":"World Health Organization.Maternal Health and Safe Motherhood Programme. Abortion: A Tabulation of Available Data on the Frequency and Mortality of Unsafe Abortion 2nd edn. Geneva Switzerland:WHO 1994."},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(97)00020-6"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/17.6.1477"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(03)00043-X"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.272.15.1190"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.3109\/13625189709167474"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70380-7"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2005.02.008"},{"key":"e_1_2_7_12_2","unstructured":"Consensus Statement: Instructions for Use\u2010Abortion Induction with Misoprostol in Pregnancies up to 9 Weeks LMP. Expert Meeting on Misoprostol sponsored by Reproductive Health Technologies Project and Gynuity Health Projects. New York:Gynuity Health Projects 2003."},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)00266-4"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(97)00173-X"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199508313330901"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/archfami.4.9.774"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70451-5"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(98)00004-3"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0010-7824(96)00113-8"},{"issue":"3","key":"e_1_2_7_20_2","first-page":"173","article-title":"Instituting medical abortion services: changes in outcome and acceptability related to provider experience","volume":"55","author":"Borgotta L","year":"2000","journal-title":"J Am Med Womens Assoc"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(00)00187-6"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199804303381801"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2005.04.032"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2004.05.003"},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2005.05.017"},{"key":"e_1_2_7_26_2","volume-title":"Induced Abortion. 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