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Medical methods of terminating pregnancy have been available in Europe and China for several years as an alternative to surgical abortion. An approach using methotrexate and misoprostol has received some limited study recently. This report from the Mt. Sinai School of Medicine describes its safety and efficacy in 178 women who were no more than 63 days pregnant. The protocol consisted of intramuscular methotrexate (50 mg/m2) followed by intravaginal misoprostol (800 micrograms) 5 to 7 days later. The misoprostol could be given once more if there was no response. For incomplete expulsion, vacuum aspiration was performed. Abortions were successful in 96 percent of patients, and 88 percent occurred within 24 hours. Twenty-five women (14 percen…