SMF204 Lecture Notes - Lecture 5: Mifepristone, Corpus Luteum, Misoprostol

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Vacuum aspiration
Dilation & curettage
Dilation & evacuation
Induced labor
Medication abortion: RU 486 – ANTI PROGESTERONE EFFECT – drug
Medical abortion – drugs that end pregnancy
A) RU 486 – Anti Progesterone Effect
1) Breakdown of endometrium
2) Embryo detaches, starts to degrade and produces
3) Less HCG, the less HCG, the more
4) Corpus luteum disintegrates, the more it degenerates, the
5) Less progesterone
6) Low progesterone = further breakdown of endometrium
7) Uterine muscle becomes more likely to contract
8) The cervix soften and is able to dilate – leads to expulsion of embryo and
 abortion inducing
B) In Canada, Methotrexate & Misoprostol – when are used together, end an
early pregnancy
Methotrexate inhibits the production of folic acid  needed for embryonic
Misoprostol makes the uterus contract, thereby expelling the embryo
This does not affect future pregnancies
Rates of Induced Abortion Procedures 2013 (excluding Quebec)
Aspiration & curettage – 76%
D&C – 5%
D&E – 6%
Surgical + Medical – 6%/3%
Medical Only – 4%
Other – <1%
Responses to Abortion
Usually positive, rarely negative
Self-esteem: predictive
Examples of when women has negative reaction, might regret:
oPregnancy intended, meaningful
oLack support for decision: parents, partner
oConflict re: decision prior
oSelf-blame re: pregnancy
o2nd trimester
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