Abortion Pill Study Suggest Ways to Limit Infection

Since receiving FDA approval in 2000 more than one million women in the United States have used a combination of the drugs mifepristone followed two day later by misoprostel to medically induce an abortion. Mifepristone, also known as RU-486, and manufactured as Mifeprex by Danco Laboratories, can be obtained only through a clinic or provider licensed to prescribed the drug. The combination is more than 95% successful in achieving an abortion without anesthesia or surgery if given within the first 49 days of the pregnancy.

Concern was raised in 2005 when it was noted that four deaths in the US due to serious infections with a little know bacteria, Clostridium sordellii. There had been one such death reported in Canada in 2001. No deaths had been seen in Europe where more women received the drugs. In the United States and Canada the mifepristone was being placed in the vagina to maximize absorption through the mucosa membrane rather than being taken orally. With the oral route some of the medication is broken down in the gastrointestinal tract making it less effective.

Since March 2006 Planned Parenthood has conducted a study were the mifepristone is placed orally between the cheek and the gums. This allows for absorption through the mucosa membrane of the mouth and avoids passage through the gastrointestinal tract. This method also avoids contact vaginal bacteria. Change to the oral route cut the infection rate by 73%

Beginning in July 2007 to further increase the safety of medical pregnancy terminations, all women at Planned Parenthood were given antibiotics orally at the time they were given the mifepristone. Previously women were only given antibiotics if they tested positive for gonorrhea or Chlamydia. Now the infection rate has been measured at 7%. This represents a 93% decrease from previously when vaginal mifepristone was used and antibiotics were only given if an infection was diagnosed.

Clearly the new policies of placing the mifepristone between the cheek and gums, along with routine administration of oral antibiotics to every woman undergoing a medical termination of pregnancy have increased the safety of the procedure.