We studied the effects of the progesterone antagonist RU 486 in 100 women with early, unwanted pregnancy (within 10 days of the expected onset of the missed menstrual period). Thirty-four women received oral doses of 400 mg (in four days), 26 received 600 mg (in four days), and 40 received 800 mg (in two days). Uterine bleeding occurred in all patients within four days of the first dose and continued for 5 to 17 days. In 85 of the women, a dramatic decrease in the plasma chorionic gonadotropin level was observed on day 6, and an empty uterus was confirmed by ultrasonography on day 13. Hence, these women were considered to have had a complete abortion. Fifteen subjects had persistently elevated plasma chorionic gonadotropin levels on day 6 and were considered not to have responded to RU 486. They all had uterine evacuation, which was facilitated by a softening of the cervix. The percentage of women with complete abortion was similar in all dosage groups. Furthermore, plasma levels of immunoreactive RU 486 were similar in subjects with and without complete abortion. The only important side effect observed in the responders was prolonged uterine bleeding in 18 percent, but neither blood transfusion nor curettage was required. We conclude that RU 486 is an effective and safe method for termination of very early pregnancy but that it should be used only under close medical supervision.
This article has been cited by other articles:
Zikopoulos, K.A., Papanikolaou, E.G., Kalantaridou, S.N., Tsanadis, G.D., Plachouras, N.I., Dalkalitsis, N.A., Paraskevaidis, E.A.
(2002). Early pregnancy termination with vaginal misoprostol before and after 42 days gestation. Hum Reprod
17: 3079-3083
[Abstract][Full Text]
Christin-Maitre, S., Bouchard, P., Spitz, I. M.
(2000). Medical Termination of Pregnancy. NEJM
342: 946-956
[Full Text]
Baird, D. T
(2000). Clinical Uses of Antiprogestogens. Reproductive Sciences
7: S49-S52
[Abstract]
Swahn, M-L., Bygdeman, M., Jun-kang, C., Gemzell-Danielsson, K., Si, S., Qiu-ying, Y., Pei-juan, Y., Mei-ling, Q., Wei-fang, C.
(1999). Once-a-month treatment with a combination of mifepristone and the prostaglandin analogue misoprostol. Hum Reprod
14: 485-488
[Abstract][Full Text]
Goldberg, J. R., Plescia, M. G., Anastasio, G. D.
(1998). Mifepristone (RU 486): Current Knowledge and Future Prospects. Arch Fam Med
7: 219-222
[Abstract][Full Text]
Spitz, I. M., Bardin, C. W., Benton, L., Robbins, A.
(1998). Early Pregnancy Termination with Mifepristone and Misoprostol in the United States. NEJM
338: 1241-1247
[Abstract][Full Text]
Spitz, I. M., Bardin, C.W.
(1993). Mifepristone (RU 486) -- A Modulator of Progestin and Glucocorticoid Action. NEJM
329: 404-412
[Full Text]
Peyron, R., Aubeny, E., Targosz, V., Silvestre, L., Renault, M., Elkik, F., Leclerc, P., Ulmann, A., Baulieu, E.-E.
(1993). Early Termination of Pregnancy with Mifepristone (RU 486) and the Orally Active Prostaglandin Misoprostol. NEJM
328: 1509-1513
[Abstract][Full Text]
Weiss, B. D.
(1993). RU 486: The Progesterone Antagonist. Arch Fam Med
2: 63-69
[Abstract]
David, H. P.
(1992). Acceptability of Mifepristone for Early Pregnancy Interruption. J Law Med Ethics
20: 188-194
Godefroid, R. J.
(1990). RU-486. JAMA
263: 947-947
[Abstract]
Baulieu, E.
(1989). Contragestion and other clinical applications of RU 486, an antiprogesterone at the receptor. Science
245: 1351-1357
[Abstract]
Djerassi, C
(1989). The bitter pill. Science
245: 356-361
[Abstract]
Huggins, G. R.
(1989). Obstetrics and Gynecology. JAMA
261: 2864-2865
[Abstract]
