title: Therapeutic abortion in early pregnancy with antiprogestogen RU486 alone or in combination with prostaglandin analogue (gemeprost).
abstract: Abortion was attempted in 39 women in early pregnancy (less than 56 days amenorrhea) with the progesterone antagonist RU486 alone (150 mg per day for 4 days) or in combination with a PG analogue, 16,16-dimethyl-trans-delta 2-PGE1 (Gemeprost) in the form of a 1 mg vaginal pessary. Complete abortion was also attempted in 5 women who received RU486 together with 2 X 1 mg PG pessaries. Vaginal bleeding followed by complete abortion occurred in 18 of 19 women who received RU486 + 1 mg PG pessary as compared to only 12 of 20 women who received RU486 alone (P less than 0.01). All women who received RU486 + 2 mg Gemeprost had a complete abortion. The onset of crampy abdominal pain (median: 3 vs 4 days) and vaginal bleeding (3 vs 3 days) was similar in the RU486 and RU486 + PG groups, respectively. Slightly less than half the patients in both groups had nausea and/or vomiting, but the incidence did not differ from that occurring prior to treatment. The mean duration (range) of vaginal bleeding [RU486 alone: 10 (0,29) days and RU486 + PG: (5,34) days], and the measured blood loss [RU486: 53 (2,227) ml and RU486 + PG: 81 (32,222) ml] did not differ significantly between the two treatments. It is concluded that the combination of RU486 and a single PG vaginal pessary is a highly effective means of inducing therapeutic abortion in early pregnancy and offers an alternative to surgery.
mesh_terms: D000019:Abortifacient Agents / Q000008:administration & dosage*; D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage*; D000032:Abortion, Therapeutic; D000282:Administration, Intravaginal; D000527:Alprostadil / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004338:Drug Combinations; D004963:Estrenes / Q000494:pharmacology*; D005260:Female; D006470:Hemorrhage; D006801:Humans; D015735:Mifepristone; D009325:Nausea; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000187:drug effects*
chemical_list: D000019:Abortifacient Agents; D000021:Abortifacient Agents, Steroidal; D004338:Drug Combinations; D004963:Estrenes; D015735:Mifepristone; C021182:gemeprost; D000527:Alprostadil