[Use of mifepristone (RU 486) in pregnancy (excluding abortion on demand). The first clinical trials]

The use of RH 486 in terminating missed abortions, in inducing labour for therapeutic abortions and in cases of fetal death in utero. Mifepristone (RU 486) is an anti-progesterone steroid and it is known to be effective in terminating early pregnancies. The authors report 34 cases of evacuation of the uterus after pregnancy has ceased to progress (because of an empty sac or the loss of fetal heart beat) using Mifepristone, after prostaglandins had been inserted. In eleven out of 18 cases Mifepristone by itself was adequate to empty the uterus with the preliminary administration of prostaglandin analogues. In 5 cases the uterus had to be curetted. In 3 cases this was not necessary. Mifepristone given 48-72 hours before prostaglandin is first administered in order to procure a termination of pregnancy makes it possible to empty the uterus within 6 to 15 hours after first giving the prostaglandins. It lessens the dose of prostaglandins needed and shortens the labour. There was no haemorrhage or obstetric complication in our cases. We cannot make any conclusion about fetal death in utero because our series is too small, but it does seem to confirm the works of Cabroll et al.