Claims for RU <strong>486</strong>/PG Abortionby the actual age of the woman’s pregnancy. This too ispoorly defined with some studies proposing a cut-offpregnancy age of 42 days (e.g. Gao et al., 1988:676; Maria etal., 1988:255), but with the larger number of studiesadvocating an outer limit of 49 days (e.g. Somell <strong>and</strong> Ölund,1990:13; Zheng, 1989:19). Trials conducted in Engl<strong>and</strong>included women who were pregnant for up to 56 days (Roger<strong>and</strong> Baird, 1987:1415; Cameron <strong>and</strong> Baird, 1988:272) or,as in the UK Multicentre Trial, 63 days (1990:481).There are a multitude of other contraindications, manyrelating to a woman’s menstrual <strong>and</strong> reproductive history.Women with evidence of menstrual irregularities areexcluded from some trials. ‘Regularity’ is defined as 28 daysplus/minus three days (Couzinet et al., 1986:1565; Grimes etal., 1988:1307). Women with fibroids, abnormal menstrualbleeding, or endometriosis were not admitted to some studies(Li et al., 1988:733). ‘Cervical incompetence’ is anothercontraindication (Grimes et al., 1988:1307; <strong>and</strong> 1990:911).Other studies exclude women with a previous abortionhistory, spontaneous or induced (Sitruk-Ware et al., 1985:243;Grimes et al., 1990:911). Past <strong>and</strong>/or present history of‘abnormal pregnancies’ including multiple <strong>and</strong> ectopicpregnancies exempts a further number of women (Rodger<strong>and</strong> Baird, 1987:1415; Sylvestre et al., 1990:645). Pelvicinflammatory disease (PID) excludes still more women(Couzinet et al., 1986:1565; Maria et al., 1988:250).Some studies rule out women who have used IUDs orhormonal contraception three months prior to or during thelast cycle in which conception occurred (Swahn <strong>and</strong>Bygdeman, 1989:293; WHO Trial, 1989a: 719). The claimthat RU <strong>486</strong>/PG abortion is the safe treatment of choice forlarge numbers of women shrinks further in the light of thesignificant number of women worldwide who use eitherIUDs or the contr aceptive pill. However, because only afew studies disallow contraceptive users from chemicalabortion treatment, what awaits women who take the pill35
RU <strong>486</strong><strong>and</strong> then attempt chemical abortion? Will their risks beidentified, or will there be further tragedies?Still more women are excluded by their medical history.Any one of the following problems is sufficient grounds fornon-treatment: allergies including asthma (Sylvestre et al.,1990:646); epilepsy (Cameron <strong>and</strong> Baird, 1986:272); adrenalinsufficiency (Sylvestre et al., 1990:645); kidney disease(Vervest <strong>and</strong> Haspels, 1985:627); gastro-intestinal disorders(Maria et al., 1988:250); liver disorder (Couzinet et al.,1986:1565); pulmonary disorder (Somell <strong>and</strong> Olund,1990:13); or simply a ‘history of serious medical disorder’(Rodger <strong>and</strong> Baird, 1987:1415).The list of contraindications continues. Any woman whohas taken steroid medication in the past 12 months (UKMulticentre Trial, 1990:481), six months (Grimes et al.,1988:1306), three months (Maria et al., 1988:250) or‘recently’ (Sitruk-Ware et al., 1990:223) is excluded. Thisexclusion is related to the antiglucocorticosteroid propertiesof RU <strong>486</strong>/PG (see Chapter Three).More critically, some non-steroidal medications may serveto reduce the effectiveness of the PG component of RU <strong>486</strong>/PG abortion. Anti-inflammatory medication, as well assimple aspirin, are known prostagl<strong>and</strong>in inhibitors.Therefore, their simultaneous use with RU <strong>486</strong>/PG almostguarantees that the abortion will be incomplete. This meansthat women have two poor alternatives (not choices!):narcotic analgesics or suffering pain that may be intolerable.Finally, in light of the documented accidents <strong>and</strong> deathfrom RU <strong>486</strong>/PG abortions linked to cardiovascularcomplications, we were astonished to find that only a fewstudies excluded women on the basis of such cardiovascularcriteria (e.g. Cameron <strong>and</strong> Baird, 1988:272). Sylvestre et al.,(1990:646) exclude women who have a history ofhypertension <strong>and</strong>/or clotting disorders. Smoking was notincluded in the contraindications of studies from 1985 to 1990,but this may change following the Roussel Uclaf warnings36
- Page 2 and 3: Renate Klein is Lecturer in Women
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- Page 8 and 9: CONTENTSINTRODUCTION 1CHAPTER ONETh
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The Role of Prostaglandins: Known a
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The Role of Prostaglandins: Known a
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The Role of Prostaglandins: Known a
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The Role of Prostaglandins: Known a
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The Role of Prostaglandins: Known a
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The Role of Prostaglandins: Known a
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The Role of Prostaglandins: Known a
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The Role of Prostaglandins: Known a
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The Role of Prostaglandins: Known a
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The Role of Prostaglandins: Known a
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The Role of Prostaglandins: Known a
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ConclusionInstead, Baulieu uses the
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Conclusionintervention. Thus, RU 48
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Conclusionbetween population contro
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ConclusionThis article, appearing i
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Conclusion‘a whole net of relatio
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ENDNOTESChapter One1The paten t lic
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Endnotes12The Journal Officiel publ
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Endnotesin Gynecology and Obstetric
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Endnotesof menses. On the third day
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EndnotesAnother such example is the
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Bibliographyand Segal, Sheldon (Eds
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Bibliographyprostaglandin F 2•. A
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BibliographyDelaney, Anne. (1991, 2
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Bibliographyresponses to the steroi
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Bibliographyabnormalities resulting
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Bibliographyprogesterone receptor b
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BibliographyOdlind, Viveca and Birg
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BibliographyBinding of the anti-pro
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BibliographyUlmann, André, Teutsch
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Bibliographytermination by vacuum a