[Abortion induced by RU 486: importance of its combination with a prostaglandin derivative]

Abstract

The antiprogesterone steroid RU 486 (17 beta-hydroxy-11 beta-(4-dimethylaminophenyl l)-17 alpha-(prop-1-ynyl) estra-4,9-dien-3-one), orally administered once (600 mg), is an efficient contragestive agent in approximately 80% of pregnant women who have been amenorrheic for up to 41 days. Later on, its use is not recommended since after 41 day of amenorrhea there is an increase in the number of incomplete expulsions. A vaginal suppository of 1 mg Gemeprost, a synthetic PG-E1 analogue, has been prescribed 36-48 hrs. after the administration of RU 486. Such a suppository cannot provoke the interruption of the pregnancy by itself. In 106 women seeking for the interruption of pregnancy, and who were amenorrheic for 49 days or less, RU 486 plus prostaglandin association led to the interruption of pregnancy in all cases, and no further instrumental intervention was required. This preliminary report suggests that this method is an efficient alternative to conventional techniques available presently.