PubMed · 9299995
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P Casner. 1997. Abortion procedure.. https://pubmed.ncbi.nlm.nih.gov/9299995/
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A short history of antihormones is presented first. After reviewing the physiologic role of progesterone in the regulation of human reproduction, the theoretical and practical implications of suspending its actions are depicted. The tested or theoretically possible applications are enumerated. The initial success of contraceptive use of antigestagens is summarized based on their own research and international publications. Obstetric application is hindered by fear of fetal antiglucocorticoid side effects. The very remarkable success in termination of pregnancy is summarized by reviewing partly their own results. The combination of antigestagen plus prostaglandin is able to terminate pregnancies both in the first and second trimester very effectively (in 95% or over) and with very few side effects. It also renders possible the medical termination of unsuccessful pregnancies with diminishing complications. Although the most important applications take place in the regulation of human fertility, the initial results in the treatment of both benign (fibroids, endometriosis) and malignant (endometrial and ductus carcinoma) gynaecological conditions are encouraging. The production of mifepristone is possible in Hungary, but due to marketing considerations and political hurdles its registration and application is not considered yet.
Medical abortion holds great promise in less-developed countries, where abortion morbidity and mortality remain high. We tested the French mifepristone-misoprostol regimen in two urban outpatient family-planning clinics (n=600) and a rural hospital (n=300) in India. 4% of urban women and 1% of rural women were lost to follow-up. Perfect use and typical-use success rates were as high as European rates at all sites. Although rural women reported fewer side-effects, most women in urban and rural settings were satisfied with their medical abortions. Medical abortion can be offered safely, effectively, and acceptably in urban outpatient clinics and rural hospitals in India.