TABLE B1.6 Interruption of Early Pregnancy with RU 486 and One or Two Doses of Misoprostol

Treatment

Total

Number of Successesa (% of total)

Number of Failuresb (% of total)

 

Mifepristone, 600 mg

385

 

 

 

Abortion before the time of administration of misoprostol (400 µg)

385

21 (5.4%)

 

 

Administration of first dose of misoprostol followed by abortion within 4 hours

364

266 (69.1%)

 

 

Later outcome

98

 

 

 

Refuse more misoprostol

27

26 (6.8%)

Ongoing pregnancy

1 (<1%)

Second dose of misoprostol

(200 µg)

71

67 (17.4%)

Partial retention

2 (<1%)

 

 

 

Synechiae with ongoing pregnancy

1 (<1%)

 

 

 

Ectopic pregnancy

1 (<1%)

Total

 

380 (98.7%)

 

5 (1.3%)

a Success was defined as interruption of pregnancy and complete expulsion of the ovum.

b Failures were defined as indicated.

SOURCE: Peyron et al. (1993).

Currently in France, a woman suspecting an unwanted pregnancy sees a physician at a first visit, and after a delay for reflection she may return (second visit) to take the RU 486 pills. Two days later, she makes a third visit to the center to receive prostaglandin and then stays for four hours. A control (follow-up) visit (the fourth) should take place 10 to 15 days later. This method is currently not applicable to heavy smokers and women older than 35. All these precautions need to be reexamined, however, and most appear to be dispensable. In the future, it is hoped that a woman would consult her physician as early as possible in the case of missed menses and then receive, if this is her choice, RU 486 from a medically competent person who will have examined her. She will then take home the misoprostol pills for self-administration 48 hours later and return for a checkup in approximately two weeks.

Although RU 486 and misoprostol are safe drugs, pregnancy itself is a risk for women, no matter whether they wish to interrupt or continue it (e.g., ectopic pregnancy is not aborted by RU 486 and may be fatal if not treated surgically). Maintaining contact with a physician is mandatory, and there should be an appropriate permanent connection with a competent medical center in case of complications. Although it may be sufficient in the vast majority of cases for physicians (preferably gyne-



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