Medication-Induced Termination of Pregnancy
This entry provides information on pharmaceutical methods used to end a pregnancy. It covers the medications commonly involved, their mechanisms of action, administration protocols, efficacy, and potential risks and side effects. This information is for educational purposes and does not constitute medical advice. Consult with a qualified healthcare professional for any decisions regarding pregnancy termination.
Pharmaceutical Agents Employed
- Mifepristone: A synthetic steroid that acts as a progesterone receptor antagonist. By blocking progesterone, it disrupts the uterine lining, leading to detachment of the pregnancy.
- Misoprostol: A synthetic prostaglandin analogue that causes uterine contractions. It is used to expel the pregnancy tissue from the uterus.
Mechanism of Action
Mifepristone
Mifepristone competitively binds to progesterone receptors in the uterus, blocking the effects of progesterone, which is crucial for maintaining a pregnancy. This leads to decidual necrosis, cervical softening, and increased uterine contractility.
Misoprostol
Misoprostol binds to myometrial cells, causing uterine contractions. It also softens the cervix, facilitating the expulsion of the pregnancy.
Administration Protocols
Typical protocols involve administering mifepristone orally, followed by misoprostol orally, buccally, sublingually, or vaginally, usually 24 to 48 hours later. Dosage and route of administration may vary based on gestational age and regional guidelines.
Efficacy
The efficacy of medication-induced termination varies with gestational age. Success rates are generally higher earlier in pregnancy. Complete termination rates are typically above 90% when the protocol is followed correctly.
Potential Risks and Side Effects
Possible side effects include cramping, bleeding (often heavier than a menstrual period), nausea, vomiting, diarrhea, headache, dizziness, and fever. Serious complications, although rare, can include incomplete termination, infection, heavy bleeding requiring transfusion, and, in extremely rare cases, death. Allergic reactions are also possible.
Follow-up Care
Follow-up is essential to confirm complete termination and assess for any complications. This may involve a clinical examination, ultrasound, or measurement of hCG levels.
Contraindications
Contraindications can include ectopic pregnancy, certain medical conditions (e.g., bleeding disorders, severe anemia, uncontrolled asthma), intrauterine device (IUD) in place (IUD must be removed first), and allergy to either medication. Consultation with a healthcare provider is crucial to assess individual risks.