Induced abortion

Question 1

Mechanism for Misoprostol

Answer 1

a prostaglandin E1 analogue
causes expulsion of uterine contents
most effective when inserted vaginally, moistened (94%)
when used alone, significantly higher rates of N/V, chills, fever, and diarrhea

a teratogen
neurological disorder “mobius syndrome” if pregnancy continues

Stimulate uterine contraction

softens the cervix

Question 2

Mechanism of action for Mifeprostone

Answer 2

MOA: inhibits progesterone
which is necessary for placental attachment

prevents fertilization and sensitizing the uterus to the effects of prostaglandin
maximal sensitization occurs at approximately 24-48 hours following administration

approx 76% effective when used alone

Question 3

How to use Mifepristone and Misoprostol

Answer 3

oral mifepristone should be administered as a dose of 200 mcg.

Then,

24 hours later, 800 mcg of oral Misoprostol can be administered at home
At 7-14 days post-treatment, evaluate to confirm that a complete termination has occurred

95-98% effectiveness rate when used 63 days or less from LMP

Question 4

Contraindication to using mifeprestone and misoprosol for abortion

Answer 4

current use of anticoagulation meds

known or suspected ectopic pregnancy

use of long term systemic corticosteroid

Question 5

Medication abortion can be completed how many days after LMP

Answer 5

70 days