Mifepristone - Medical Termination of Pregnancy

Medical termination is the recommended procedure for patients with a gestation less than 9 weeks. It is a non-surgical procedure ideal for patients wishing to terminate an early pregnancy without having a surgical operation or anaesthetic or in later pregnancies without experiencing the small risks associated with a surgical termination.

Criteria
Abortion Medication may be an option if you:
• Are less than 8 weeks since your last menstrual period.
• Are willing and able to give informed consent.
• Have the support you need such as access to reliable transportation and ability to communicate with the clinic by telephone.
• Live no more than 2 hours away from emergency medical care (a hospital).
• Are able to come back to the clinic for 1 to 3 follow-up appointments.
• Agree to have a surgical abortion if the misoprostol does not induce termination.

This treatment may not be suitable for you if any of the following apply :
• High blood pressure
• High cholesterol
• Asthmatics on long term corticosteroid treatment
• Taking any anticoagulant treatment
• Aged over 35 years of age and smoke more than 10 cigarettes per day, or under 35 years and smoke more than 20 cigarettes a day

The above points will be discussed with you by the doctor. If any of these conditions apply please inform the doctor or nurse.

Your Health
Due to the risk of serious health problems, mifepristone and misoprostol may not be recommended if you:
• Have had a blood clotting problem or are taking anticoagulant medicine.
• Have severe anemia.
• Have adrenal failure.
• Are taking long-term systemic corticosteroids.
• May have an ectopic pregnancy.
• Have a mass in the tubes or ovaries.
• Have inherited porphyria.
• Have an allergy to mifepristone, misoprostol or other prostaglandin medicine.
• Have severe diarrhea.

How Does it Work?
Mifepristone blocks the hormone progesterone needed to maintain the pregnancy. Because this hormone is blocked, the uterine lining begins to shed, the cervix begins to soften and bleeding may occur. With the later addition of the second medication, misoprostol, the uterus contracts and the pregnancy is usually expelled within 6 to 8 hours. How RU486 works
Mifepristone is typically given with gemeprost (a prostaglandin). Mifepristone sensitises the myometrium (the muscular wall of the uterus) to prostaglandin-induced contractions and it softens and dilates the cervix. Gemeprost stimulates the uterus to contract which leads to the foetus being expelled from the womb. Misoprostol is a prostaglandin E1 analogue approved by the Food and Drug Administration (FDA) for the prevention and treatment of peptic ulcer disease in patients taking non-steroidal anti-inflammatory drugs. It has also become an important drug in obstetric and gynecologic practice because of its uterotonic and cervical ripening activity. Misoprostol is useful in the management of elective medical and surgical abortion, miscarriage, induction of labor, and postpartum hemorrhage. In contrast to other prostaglandin preparations, misoprostol does not require refrigeration or parenteral administration. It is also inexpensive.

Is it Safe?
Many women, world-wide, have used this treatment and it has been proven to have a very good safety record. However, every form of medical treatment has some potential risks or side effects. With this treatment the main risks, though very small, are excessive vaginal bleeding, incomplete abortion and infection. These are usually treated very easily. The nurse caring for you will be happy to explain these in more detail.
You may bring one adult supporter with you if you wish to do so. For late medical terminations your supporter will be asked to wait in the waiting areas. If you have children, please make arrangements for them to be cared for at home when you visit the clinic.

 You must be able to attend for 2 or possibly 3 separate visits as advised:
At your first appointment at the clinic, an ultrasound is performed to confirm you are less than 8 weeks pregnant. You then speak with an experienced counselor who explains how mifepristone and misoprostol work and makes sure you get answers to all of your questions. Your health history is carefully reviewed and if you meet the criteria, the doctor will give you the mifepristone to take orally.

Your Second Appointment
8-10 days from the 1st clinic visit, you must return for a 2nd appointment for an ultrasound.
Remember, the abortion is not complete until the ultrasound on your final visit. Even if you bled heavily, cramped, and passed clots, you can still be pregnant! There is no extra charge for this ultrasound or for a surgical procedure in the event of a failed abortion.


What To Expect
Upon taking mifepristone at the clinic you may begin to bleed. As each woman's body is different, bleeding varies from woman to woman. Some may experience light bleeding much like spotting towards the end of a menstrual period. Others have heavier bleeding like their regular menstrual period, or like a heavy period. Some women do not experience any bleeding until taking the misoprostol.

Side Effects
Most of the side effects when using this early abortion option are caused by the second medication, misoprostol. Side-effects may include heavy bleeding, headache, nausea, vomiting, diarrhea, and heavy cramping.

Risks
Vaginal bleeding with medical abortion could be extremely heavy. In rare situations it could require a aspiration abortion and very rarely, a blood transfusion. You will be given our 24-hour hotline number to call if you have any problems. Medical staff are on call at all times to answer your medical questions and concerns.

If pregnancy is continued after taking these medications, there is a high risk of fetal deformities

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http://www.hopeclinic.com/WhatToExpectFirstTrimester.htm
http://www.smpclinic.co.uk/mthowsafe.html
http://www.fwhc.org/abortion/medical-ab.htm
http://www.medic8.com/healthguide/articles/ru486.html