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  • Title: The clinical use of RU 486 (Mefipristone).
    Author: Herrmann W.
    Journal: Res Reprod; 1989 Oct; 21(4):3. PubMed ID: 12282921.
    Abstract:
    RU-486, which has proven efficacy as an abortifacient in early pregnancy and potential as a contraceptive or contragestive, represents one of the most promising new approaches to population control. Clinical trials have demonstrated that 60-85% of women with pregnancies of 8 weeks' duration or less will experience complete abortion after a single dose of 6000 mg/os of RU-486 and a further 10-20% will in addition require surgical intervention. These rates are improved significantly by the addition of a small single dose of a synthetic prostaglandin. No side effects directly attributable to the antiprogesterone have been reported, and bleeding in RU-486-induced abortions is comparable to that after vacuum aspiration. Other applications in pregnancy include the induction of labor at or near term in cases of intrauterine death and termination of 2nd-trimester pregnancies in combination with oxytocic agents. When RU-486 is administered during the follicular development phase of the menstrual cycle, ovulation is delayed for several days. Administration shortly after ovulation inhibits corpus luteum formation. Careful timing of RU-486 treatment is essential to gain an effective luteolytic effect, and more study is need to understand the reduced effectiveness of RU-486 as a menstrual inducer in the presence of human chorionic gonadotropin. In short, RU-486 has immense potential, but many unanswered questions remain regarding its mechanism of action during pregnancy and the various phases of the menstrual cycle.
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