Termination of pregnancy or abortion is sometimes indicated in certain circumstances. There are different methods by which abortion can be carried out. These can either be medical or surgical approaches. This essay discusses the use of RU-486 as one of the medical abortion techniques. It discusses the mechanism of action of this drug, its safety and use in the United States.
This drug has provided a better option to the usually surgical technique of abortion. It leads to early abortion in women during pregnancy. In pregnancy, progesterone hormone is usually very important for the maintenance of the pregnancy. The mechanism of action of RU-486 is to block the receptors of this hormone (it is antiprogesterone). This is through competition with progesterone for its receptor attachment sites. Its inhibition effect is both with exogenous and endogenous progesterone (National Abortion Federation, 2008).
It works best in the early stages of pregnancy (about 0 to 50 days). It is most commonly combined with prostaglandins at minimal dose to make it more effective and reduce the side effects. Therefore, after taking the oral single dose, gemeprost (prostaglandin) is administered intravaginally. Prostaglandins usually stimulate and increase the contraction of the uterine muscles. Mifepristone will cause sensitization of the uterus muscles (myometrium) to the gemeprost. It also softens and enhances the dilatation of the cervix. These events will lead to termination of the pregnancy. Research in most pregnant women (about 90-95%) has proved the effectiveness of mifepristone (Costa, 2007).
However, this drug has a number of side effects. These include; abdominal pain, vomiting, bleeding. Nausea, cramping, weakness and sometimes diarrhea (Costa, 2007).
This drug has been tested continuously and found to be effective and safe in most women hence its recommendation in most countries. Despite this, it has created controversies and confusions. Some people have been made to believe that it is the same as morning after pills. Furthermore, the advertisements do not clearly indicate the risks and contraindications of this drug. In this way, most women are misinformed and end up being confused on whether to use or not to use this drug. In cases where the drug is not effective, surgical abortion is recommended. It is recommended that patients are closely monitored following the treatment by this drug. This will help in determining whether the pregnancy has been terminated completely or not. This is done through an ultrascan and clinical examination. Persistent bleeding past 30 days would indicate an incomplete termination. However, research has shown that in most women, bleeding usually occurs between 9 and 15 days (Costa, 2007).
The drug should be allowed to continue being in the market. This is due to the fact that it poses a lesser risk to the patient as compared to the other methods such as surgical procedures. The abortion occurs at an early stage (during the first trimester of pregnancy). Medical and surgical abortions have higher risks. Furthermore, more tests concerning the possibility of developing cancer have shown that it is not carcinogenic. If the correct protocol is followed, this drug is quite effective and hence should continue to be in the market.
Costa, C. D. (2007). RU 486. Salisbury: Boolarong Press.
National Abortion Federation. (2008). Facts about Mifepristone (RU-486). Retrieved on 17 August, 2010 from http://www.prochoice.org/about_abortion/facts/facts_mifepristone.html.