Voluntary interruption of pregnancy with mifepristone (RU 486) and a prostaglandin analogue

Article Abstract:

Mifepristone, also called RU 486, is a drug developed and currently available in France to interrupt pregnancy during its early stages (49 days or less after the woman's last menstrual period). It is administered orally and followed 36 to 48 hours later by a drug from the prostaglandin family, a group of compounds that can cause muscle contraction. The efficacy of mifepristone in conjunction with two different prostaglandin-like drugs was tested on 2,040 women at 73 different medical centers in France who elected to terminate their pregnancies in this manner. The prostaglandin-like drugs used were either oral gemeprost, at a single dose, or injected sulprostone at three different doses. A success was defined as complete termination of the pregnancy with expulsion of the uterine contents and no need for any additional surgical procedure. Any other outcome was considered a failure. Using these criteria, the overall success rate was 96 percent, with slightly greater success among women who received the higher dose of sulprostone. Pregnancy failed to be interrupted in one percent of the women and was incompletely interrupted in 2.1 percent. One woman who had not yet received the prostaglandin-like drug required a blood transfusion. The average time until expulsion of the products of conception was shortest for the higher dose of sulprostone and duration of bleeding was longer for the highest two doses of this drug. These women also reported the most pain. Side effects such as nausea, vomiting, and diarrhea were reported but were usually mild. The efficacy of this combination of mifepristone and a prostaglandin-like drug is comparable with that of vacuum aspiration for termination of pregnancy at the same stage and complications leading to blood loss were no more frequent. Although data have not been gathered, laboratory results indicate that a fetus that survives an attempted interruption of pregnancy with these drugs may be deformed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Methods, Prostaglandins, Abortion, Birth control

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Induction of abortion with mifepristone (RU 486) and oral or vaginal misoprostol

Article Abstract:

Misoprostol given as a vaginal suppository may be effective in inducing abortion when used in conjunction with mifepristone (RU 486). Misoprostol has been used to treat peptic ulcer. A total of 263 women in their first trimester of pregnancy took 600 milligrams of mifepristone and returned to a clinic three or four days later. One hundred-thirty took 800 micrograms of misoprostol orally and 133 inserted 800 micrograms of the drug into their vagina. Abortion occurred within four hours in 78% of the women who took the drug orally and 93% of those who used a vaginal suppository. Fewer women who used the suppository experienced nausea, vomiting and diarrhea. The incidence of other symptoms such as headache and hot flashes was approximately the same in both groups. Vaginal misoprostol appears to be as safe as vaginal gemeprost, another prostaglandin derivative used to induce abortion.

Vagina, Medication by, Vaginal medication, Abortifacients

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Early termination of pregnancy with mifepristone (RU 486) and the orally active prostaglandin misoprostol

Article Abstract:

Combining mifepristone (RU 486) and misoprostol appears to be safe and effective in the early termination of pregnancy. Given alone, mifepristone incompletely terminates pregnancy in about 20% of women. Administering a prostaglandin either in muscle or the vagina improves the effectiveness of mifepristone but is uncomfortable and can cause side effects. Among 488 women, abortion was complete after receiving mifepristone alone in 14 women. In 459 of the women, abortion was complete after receiving mifepristone and an oral dose of misoprostol. The overall success rate of 96.9% is comparable to the 95% success rate seen with mifepristone and intramuscular and intravaginal administration of prostaglandin. In a second study of 385 women, pregnancy was terminated after receiving mifepristone alone in 21 women and after receiving mifepristone and oral misoprostol in 359 women.

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