Medical Abortion with Mifepristone (Mifegyne®/Mifeprex®)
Progesterone, also called courpus luteum hormone is essential for the normal development of a pregnancy. Mifepristone is a drug which inhibits the function of progesterone selectively. By taking Mifepristone a pregnancy is terminated, similarly to an early spontaneous abortion. Another hormone, prostaglandin, has to be taken two days after Mifepristone to assure expulsion of the gestational sac. If the patient wishes to see the expulsed gestational sac they have to take a close look into their pads or into the lavator
What is it used for?
- Termination of pregnancy in the first trimester (up to 63 days).
- Softening and dilation of the cervix (neck of the womb) prior to surgical termination of pregnancy.
- To prepare the uterus for treatment with prostaglandins when a pregnancy needs to be terminated after three months.
- To induce labour if a pregnancy has been interrupted (foetus has died in the uterus).
How does it work?
Mifegyne tablets contain the active ingredient mifepristone, which is a type of medicine known as an anti-progesterone. Mifepristone acts by blocking progesterone receptors in the uterus and this reduces the effectiveness of the natural hormone progesterone.
Progesterone plays an important role in the maintainance of pregnancy such as the successful implantation of the fertilised egg into the wall of the uterus and prevention of uterine contractions during pregnancy. By blocking progesterone receptors in the uterus, mifepristone significantly reduces progesterone levels so that pregnancy cannot be maintained. Abortion may occur solely as a result of the actions of mifepristone, but surgery may also be necessary to remove the foetus.
Treatment with Mifegyne tablets is always carried out under the supervision of a doctor.
- Mifepristone may only be used for pregnancy termination in accordance with the Abortion Act 1967 as amended by The Human Fertilisation and Embryology Act 1990.
- Mifepristone must be given under the supervision of a registered medical doctor.
- Both administration of mifepristone and follow-up must take place in an NHS hospital or place approved by the Secretary of State under section 1 (3) of the Abortion Act 1967 and which has received approval by the Department of Health to undertake medical terminations with mifepristone.
- A follow-up visit is recommended at an appropriate interval (usually 14 to 21 days) after taking mifepristone.
- Mifepristone must not be given if there is doubt as to the existence and age of the pregnancy. The prescribing doctor should perform the appropriate tests to determine the age of the foetus, eg an ultrasound scan.
- If treatment fails or is interrupted, the pregnancy is likely to continue to develop. Exposure to mifepristone may present a high risk of malformation to the foetus. In this event, termination by another method is advised to be undertaken at the follow-up visit.
- You will experience vaginal bleeding, one or two days after treatment with mifepristone. This can last for up to 12 days. If you experience heavy or prolonged bleeding consult your doctor.
- It is possible for a pregnancy to occur soon after treatment with mifepristone. An reliable method of contraception such as condoms, should be used until the next menstrual period.
How does the medical abortion work?
Taking Mifepristone and a prostaglandin is a very safe and effective method which leads to a successful abortion in 98% of cases. Taking the prostaglandin may cause menstrual disorders like cramping in the lower abdomen; taking paintreatment might therefore be necessary. We offer you to stay in the clinic for a couple of hours after intake of the prostaglandin. If you prefer to take the prostaglandin tablets at home, you should have painkillers on hand.
In Austria and most other European countries this method is approved up to the 9th week of pregenancy
(weeks are counted from the first day of the last menstrual bleeding).
- as part of a voluntary abortion until the 9th week (Projected from the 1st day of the last period.)
- for the late abortion in a hospital due to a medical necessity
- the opening of the cervix prior to surgical abortion.
The medical abortion with Mifegyne® takes a couple of days. It allows you to keep control over your body and to experience the treatment. Therefore you may be able to review misconceptions about the process.