THE EFFICACY OF ORAL MIFEPRISTONE (RU-38,486) WITH A PROSTAGLANDIN-E1 ANALOG VAGINAL PESSARY FOR THE TERMINATION OF EARLY-PREGNANCY - COMPLICATIONS AND PATIENT ACCEPTABILITY

Outpatient terminations were performed on 100 ultrasonographically confirmed pregnancies of ≤63 days with a single oral dose of RU 38,486 (600 mg) and a single vaginal pessary of 16,16-dimethyl-trans-Δ2-prostaglandin E1 (1 mg) 48 hours later. Abortion occurred in all patients; in 95 it was complete, in four it was incomplete, and one resulted in a missed abortion. In 88% the abortion occurred within 4 hours of prostaglandin treatment. A total of 25% of patients had nausea and 15% vomited after RU 38,486 treatment. After prostaglandin treatment, 13% vomited, 10% had diarrhea, and 23% required administration of an opiate analgesic agent. No patient was transfused and there was no genital tract trauma; one case of suspected pelvic infection occurred. If the need for termination arose again, 88% would elect to use the method again, 9% would not. The combination of the antiprogestin RU 38,486 and a vaginal prostaglandin pessary appears to offer a safe, efficient, acceptable nonsurgical outpatient method of termination. Further studies on dosage and treatment protocols would be justified. © 1990.