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Background: Induced abortion is the medical or surgical terminationof pregnancy before fetal viability. It has maternal orfetal indications. The aim of the present study was to evaluatethe efficacy of the combination of methotrexate and misoprostolfor termination of the pregnancy in the first trimester.Methods: This analytic study was performed on 100 women atthe first trimester of pregnancy (<14th week), during 2004-2006. Each woman received intramuscular methotrexate (50mg/m2) and intravaginal misoprostol (800 μg) 72 hours aftermethotrexate administration. The second dose of misoprostolwas administered if abortion did not occur after 24 hours. Abdominalultrasonography was performed 7 days after abortion.Results: Of the 100 women, 76 had gestational age >9 weeksand 24 has gestational age<9 weeks. Eighty one women (81%)had successful medical abortion and 19% women required curettage.Fifty nine patients with gestational age>9 weeks and22 patients with gestational age <9 weeks had complete abortion.Failure rate was higher in missed abortion. Required doseof misoprostol and duration of conceptus expulsion werehigher in pregnancies with missed abortion.Conclusion: Combination therapy with methotrexate and misoprostolrepresents a safe and effective alternative to invasivemethods for termination of the pregnancy in the first trimester.