Medical abortions have become popular in the U.S. Since 2001 the FDA approval of RU 486 for pregnancy from 3 to 7 weeks. Before 2001, abortions Doctors often conducted methotrexate. Methtrexate was adopted by the FDA in late 1950 for the treatment of certain cancers. Since then it has been used to treat psoriasis and rheumatoid arthritis.
Methotrexate is known to cause serious miscarriages and fetal abnormalities in the first trimester of pregnancy (up to 12 weeks gestation). Patients diagnosed as pregnant delay treatment for their particular disease until after delivery, or choose to undergo an abortion, especially in the first trimester of pregnancy.
A mid 80's, extensive research was not documented in medical literaturethat discuss the treatment tubal ectopic pregnancy (pregnancy outside the uterus). Methotrexate targets and destroys certain parts of the pregnancy tissue (trophoblast) necessary for growth fetal. Without the trophoblastic tissue, the tissue of pregnancy reduced in size and disappears preventing the need for surgery.
It has been observed in patients under 6 weeks of gestation takes 25-30 days after receiving methotrexate, for the uterus begin to contract and expel the pregnancy tissue. In order to reduce the time it took to complete the abortion process, Cytotec (misoprostol) was added. Cytotec is a prostaglandin known to cause uterine contractions. The changes are also produced locally in the cervix (the lower abdomen of the mother) allowing the cervix to dilate (open) and become soft and sweet that makes the pregnancy tissue to be expelled from the uterus. This process can last on average between 1 and 14 days to complete. Some patients may take longer. On average, is a rate of 5-12% failure using the combination of methotrexate and cytotec to carry out the abortion procedure in patients between 3 and 9 weeks of pregnancy. Patients under 6 weeks of gestation have a rate of 97-99% success. In essence, the beginning of pregnancy, the medical abortion procedure is performed, the more successful rate.
Cytotec methotrexate abortions and are associated with few complications. Given the small dose of methotrexate used, there are minimal side effects. These inculde the possibility of cystitis (bladder irritation) a rash with excessive sun exposure. Hair loss and a low number blood cells were not observed in our clinical practice. Other advantages of methotrexate is that it is expensive to use, and can be administered by injection or mouth. For patients who are unable to contain liquids or food because of nausea and vomiting, giving intramuscular methotrexate is an excellent choice.
Complications associated with the procedure of abortion, generally canned (tissue left behind in the uterus) or failure of the procedure Persistent or excessive bleeding, all of which require a surgical abortion procedure performed. In rare cases, blood transfusions were required, and there have been reports sporadic deaths due to a rare infection. There is no conclusion that these deaths are caused directly by the abortion procedure.
In conclusion, medical abortion with methotrexate and cytotec has been used for many years to end pregnancies up to nine weeks of gestation. Although not as effective as RU486 after 6 weeks of gestation to terminate the pregnancy, has been found to be as effective in patients younger than 6 weeks .. For patients who are allergic to the pill RU486, unable to swallow pills that are experiencing nausea and vomiting, or have other contraindications, including adrenal insufficiency, the use of methotrexate is a viable alternative.