Failed medical termination of twin pregnancy with mifepristone: a case report


      Medical abortion with mifepristone and misoprostol is a two-step process where some women will change their minds about going through the abortion process after taking mifepristone. Of these, some pregnancies will continue. A woman with a twin pregnancy who changed her mind is presented. Twin pregnancies may need higher dosages of mifepristone than single pregnancies due to the presence of two corpora lutea and increased amount of trophoblast tissue. There is little, if any, documentation regarding congenital abnormalities after taking mifepristone. Therefore, there is little evidence to support persuasion of the patient to continue the abortion process with the prostaglandin analouge.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Contraception
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Christin-Maitre S.
        • Bouchard P.
        • Spitz I.M.
        Medical termination of pregnancy.
        N. Engl. J. Med. 2000; 342: 946-956
        • World Health Organisation Task Force on Post-Ovulatory Methods of Fertility Regulation
        Termination of pregnancy with reduced doses of mifepristone.
        BMJ. 1993; 307: 532-537
        • Sitruk-Ware R.
        • Davey A.
        • Sakiz E.
        Fetal malformation and failed medical termination of pregnancy.
        Lancet. 1998; 352: 323
        • Couzinet B.
        • Le Strat N.
        • Ulmann A.
        • Baulieu E.E.
        • Schaison G.
        Termination of early pregnancy by the progesterone antagonist RU 486 (mifepristone).
        N. Engl. J. Med. 1986; 315: 1565-1570
        • Kahn J.G.
        • Becker B.J.
        • MacIsaa L.
        • et al.
        The efficacy of medical abortion: a meta-analysis.
        Contraception. 2000; 61: 29-40
        • Speroff L.
        • Glass R.H.
        • Kase N.G.
        The endocrinology of pregnancy.
        in: Speroff L. Glass R.H. Kase N.G. Clinical gynecologic endocrinology and infertility. Williams & Wilkins, Baltimore1994: 251-289
        • Ashok P.W.
        • Flett G.M.
        • Templeton A.
        Termination of pregnancy at 9���13 weeks' amenorrhoea with mifepristone and misoprostol.
        Lancet. 1998; 352: 542-543
        • Spitz I.M.
        • Bardin C.W.
        • Benton L.
        • Robbins A.
        Early pregnancy termination with mifepristone and misoprostol in the United States.
        N. Engl. J. Med. 1998; 338: 1241-1247
        • Baulieu E.E.
        Contragestion and other clinical applications of RU 486, an antiprogesterone at the receptor.
        Science. 1989; 245: 1351-1357
        • Blanch G.
        • Quenby S.
        • Ballantyne E.S.
        • Godsen C.M.
        • Neilson J.P.
        • Holland K.
        Embryonic abnormalities at medical termination of pregnancy with mifepristone and misoprostol during first trimester: observational study.
        BMJ. 1998; 316: 1712-1713
        • Pons J.C.
        • Imbert M.C.
        • Elefant E.
        • Roux C.
        • Herschkorn P.
        • Papiernik E.
        Development after exposure to mifepristone in early pregnancy.
        Lancet. 1991; 338: 763
        • Lim B.H.
        • Lees D.A.
        • Bjornsson S.
        • et al.
        Normal development after exposure to mifepristone in early pregnancy.
        Lancet. 1990; 336: 257-258
        • Henrion R.
        RU 486 abortions.
        Nature. 1989; 338: 110
        • Ulmann A.
        • Rubin I.
        • Barnard J.
        Development after in-utero exposure to mifepristone.
        Lancet. 1991; 338: 1270
        • Gonzalez C.H.
        • Marques-Dias M.J.
        • Kim C.A.
        • et al.
        Congenital abnormalities in Brazilian children associated with misoprostol misuse in first trimester of pregnancy.
        Lancet. 1998; 351: 1624-1627
        • Fonseca W.
        • Alencar A.J.
        • Pereira R.M.
        • Misago C.
        Congenital malformation of the scalp and cranium after failed first trimester abortion attempt with misoprostol.
        Clin. Dysmorphol. 1993; 2: 76-80
        • Pastuszak A.L.
        • Schuler L.
        • Speck-Martins C.E.
        • et al.
        Use of misoprostol during pregnancy and Mobius' syndrome in infants.
        N. Engl. J. Med. 1998; 338: 1881-1885
        • Orioli I.M.
        • Castilla E.E.
        Epidemiological assessment of misoprostol teratogenicity.
        BJOG. 2000; 107: 519-523