Related Experiment Videos
Methotrexate compared with mercaptopurine for early induced abortion.
A R Davis1, L Miller, H Tamimi
1Department of Obstetrics and Gynecology, Columbia University, New York, New York 10032, USA. daviann@cpmc3.cpmc.columbia.edu
Obstetrics and Gynecology
|June 11, 1999
Summary
Oral 6-mercaptopurine failed to induce early abortion. A single dose of methotrexate effectively induced abortion in most women under 6 weeks gestation, with reduced cell proliferation.
Area of Science:
- Reproductive Medicine
- Pharmacology
- Gynecology
Background:
- Medical abortion utilizes pharmacological agents to terminate early pregnancies.
- Antimetabolites like methotrexate and 6-mercaptopurine are used in various medical treatments.
Purpose of the Study:
- To compare the efficacy of methotrexate and 6-mercaptopurine as single-agent medical abortifacients.
- To analyze clinical outcomes and immunohistochemical markers of cell proliferation.
Main Methods:
- Randomized trial comparing intramuscular methotrexate (50 mg/m2) with oral 6-mercaptopurine (200 mg) in early gestations (<7 weeks LMP).
- Clinical follow-up for fetal cardiac activity and abortion completion.
- Immunohistochemical analysis of fetal tissues using the Ki-67 assay for cell proliferation.
Main Results:
- 6-mercaptopurine arm discontinued due to 100% failure rate (all women had fetal cardiac activity).
- Methotrexate induced abortion in most women (<6 weeks gestation), with a higher success rate than in those between 6-7 weeks.
- Tissues exposed to methotrexate showed significantly lower Ki-67 activity compared to 6-mercaptopurine.
Conclusions:
- Oral 6-mercaptopurine (200 mg) is ineffective for early medical abortion.
- Single-dose intramuscular methotrexate is effective for early abortion (<6 weeks gestation) without prostaglandins.
- Methotrexate reduces fetal tissue cell proliferation, as indicated by lower Ki-67 activity.