Approved for use in the US in September of 2000, mifepristone is a medication used in combination with misoprostol to facilitate 1st trimester abortion (medical abortion). While misoprostol causes the uterus to contract, mifepristone is responsible for blocking the action of the progesterone needed to sustain a pregnancy, causing changes in the uterine lining, detachment of the pregnancy, and opening of the cervix.1
Between 2000 and 2005, there were over 208,000 legally induced medical abortions performed in the US2. Over a 4-year span during that time, more than 600 Adverse Event Reports (AER) were submitted to the FDA regarding mifepristone-administered abortions.
- 237 cases of hemorrhage: 1 fatal, 42 life threatening, and 168 serious; 68 required transfusions.
- 66 cases of infection: 7 cases of septic shock (3 fatal, 4 life threatening) and 43 cases requiring parenteral antibiotics.
- 513 cases required surgical intervention: (235 emergent, 278 non-emergent). Emergent cases included 17 ectopic pregnancies (11 ruptured).
- 22 cases reported second trimester viability (meaning the abortion was unsuccessful and the pregnancy carried into its 2nd term): of the 13 documented follow-ups, 9 were terminated without comment on the state of the fetus, and 3 fetuses were diagnosed with serious malformations, suggesting a malformation rate of 23%.
Hemorrhage and infection are the leading causes of mifepristone-related morbidity and mortality.3
1 National Abortion Federation. (2008). Facts About Mifepristone (RU-486). Retrieved from: http://www.prochoice.org/about_abortion/facts/facts_mifepristone.html
2 Centers for Disease Control. (2006). Lilo T. Strauss, MA, Sonya B. Gamble, MS, Wilda Y. Parker, Douglas A. Cook, MBIS, Suzanne B. Zane, DVM, Saeed Hamdan, MD, PhD. Division of Reproductive Health. National Center for Chronic Disease Prevention and Health Promotion. Abstract: Abortion Surveillance — United States, 2000 [-2005].2000 |2001 |2002 |2003|2004|2005
3 A. Pharmacother. (2006). Feb;40(2):191-7. Epub 2005 Dec 27. Analysis of severe adverse events related to the use of mifepristone as an abortifacient. Gary MM, Harrison DJ. American Association of Profile Obstetricians and Gynecologists, Eau Claire, MI 49111-0414, USA. http://www.ncbi.nlm.nih.gov/pubmed/16380436