Induction of early abortion with mifepristone (RU486) and two different doses of prostaglandin pessary (gemeprost)

Abstract

One-hundred-and-twenty women of less than 56 days amenorrhoea were treated with a single dose of 600 mg of mifepristone in combination with half or a whole 1 mg gemeprost vaginal pessary. Complete abortion was induced in 119 (99%) women and there were no continuing pregnancies. There were few gastro-intestinal side effects following prostaglandin. The smaller dose of prostaglandin caused significantly less severe pain. This study confirmed the effectiveness of mifepristone and prostaglandin for the induction of early abortion but suggests that more research should be carried out to determine the lowest effective doses of both drugs.

PIP: Prostaglandin analogues have successfully been used to induce abortions in women of less than 7 weeks amenorrhea, but about 50% of these women have experienced vomiting, diarrhea, or moderate to severe pain. The antigestagen mifepristone has led to fewer side effects, but the incidence of incomplete abortion has been unacceptably high. To test the efficacy and side effects of these drugs when used in combination, 120 women of less than 56 days amenorrhea received a single 600 mg dose of mifepristone and 48 hours later 1/2 or 1 mg of the prostaglandin gemeprost administered in vaginal pessary form. Complete abortions were experienced by 119 (99%) of the women. There were no continuing pregnancies and only 1 of the women required surgical intervention. There were few gastrointestinal side effects following administration of prostaglandin, and when the smaller dose of prostaglandin was used there was a significant decrease in the incidence of severe pain. More research needs to be undertaken to determine the lowest effective doses of both drugs.