Ru 486 Misconceptions Myths and Morals - ressourcesfeministes

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The Role of Prostaglandins: Known and Unknown Dangerscimetidine and, since it is free of gastrointestinal side-effects,it remains the preferred gastric ulcer therapy. In contrast,the gastrointestinal side-effects of PGs in abortion proceduresare trivialized, when diarrhea, superimposed on abortion’sphysical and psychological demands, is especiallydehumanizing.In healthy humans, the effect of both PGE 1and PGE 2isto increase the heart rate. Cardiovascular (heart and bloodvessel) collapse has been observed following the obstetricaland gynecological use of PGs and is attributed to PG escapinginto the blood stream which causes severe pulmonaryhypertension and/or anaphylactic shock (an exaggerated andlife-threatening allergic reaction). In anaesthetized pregnantwomen, PGs increase pulmonary resistance by 100 per centand cause a three fold increase in work for the right side ofthe heart (Secher et al., 1982). Even a minimal amount ofPG, instilled intra-amniotically, can cause cardiovascularcomplications by leaking into the blood stream. Roussel Uclafhas expressed its concern for the cardiovascular hazards ofsynthetic PGs—no doubt reinforced by identical complicationsthat caused the death of a 31-year-old woman in March,1991—and warns that RU 486/PG termination iscontraindicated for women with history of cardiovascularrelatedconditions such as angina, cardiac arrhythmia, heartfailure and high blood pressure.Endogenous PGs have an important role in maintainingkidney function in patients with renal disease, so thatmedications which are PG-inhibitors, including many nonsteroidal,anti-inflammatory drugs such as aspirin, can causeepisodes of acute renal failure. Waltman et al., (1973)recognized the importance of the PG-inhibiting property ofcertain medications in the context of abortion. They reportedthat women taking aspirin and indomethacin had asignificantly delayed onset of abortion, compared with womenreceiving the same abortion treatment but not taking antiinflammatorydrugs. In relation to RU 486/PG-induced85
RU 486abortion, this means that many mild analgesics areinappropriate for counteracting the pain, as their use wouldfurther delay the onset of abortion and/or further increasethe chemical abortion failure rate. This accounts for theprescription of opiate analgesics, pethidine for example, tocounteract the pain from RU 486/PG treatment. We wouldsuspect that women taking anti-inflammatory drugs, such asIndocin, Clinoril, Advil, Motrin or Naprosyn for arthritisrelatedinflammatory conditions, are at increased risk ofincomplete abortion. Roussel Uclaf does not warn RU 486/PG consumers against the combined use of anti-inflammatorydrugs and chemical abortion.RU 486 proponents, especially those in the US, claimthat chemical abortion progress is hindered by the absenceof PG preparations that are appropriate for RU 486 salvageoperations. This is viewed as a stumbling block to swiftlicensing of RU 486 and ‘a small dose of prostaglandin’ by healthauthorities. G.D. Searle (USA) and Schering (Germany),which respectively manufacture Cytotec (misoprostol) andNalador (sulprostone), have given us reason to understandthat their products are not marketed for use with RU 486 inabortion procedures. Schering’s comment of 19 March 1991reads: ‘We do not indicate the use of our product incombination with Mifepristone. Our information materialon Nalador does not make any reference to such acombination’ (pers. comm. to LD and RK).Many assume that fear of moral backlash accounts for thereluctance of pharmaceutical companies to market PGs informs suitable for abortion purpose. However, ‘off-label’prescription of drugs is a frequent medical practice, oncegovernment approval has been obtained for a drug’s specified(‘on-label’) use. 2 Thus, even if PGs are not licensed asabortifacients, this does not preclude their ‘off-label’ use withRU 486 in abortion procedures. Nalador and Cytotec arealready two PGs which have been prescribed in this fashion,in the UK, France and Sweden, to terminate pregnancy with86
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Renate Klein is Lecturer in Women
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RU 486Misconceptions,Myths and Mora
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ACKNOWLEDGEMENTSWe would like to ex
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CONTENTSINTRODUCTION 1CHAPTER ONETh
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INTRODUCTIONInitial euphoria greete
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IntroductionUnfortunately, objectio
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Introductiondo not know or do not a
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Introductionused widely for years a
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CHAPTER ONEThe History of RU 486RU
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The History of RU 486consultants ar
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The History of RU 486Events in Fran
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The History of RU 486service of wom
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The History of RU 486The result app
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The History of RU 486developing cou
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The History of RU 486University Hos
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The History of RU 486pharmacovigila
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CHAPTER TWOClaims for RU 486/PG Abo
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Claims for RU 486/PG Abortionsevera
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Claims for RU 486/PG Abortionthe Br
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Claims for RU 486/PG Abortionan imm
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Claims for RU 486/PG Abortionby the
Page 44 and 45: Claims for RU 486/PG Abortionby the
Page 46 and 47: Claims for RU 486/PG Abortionfrom A
Page 48 and 49: Claims for RU 486/PG Abortioncommen
Page 50 and 51: Claims for RU 486/PG AbortionSome s
Page 52 and 53: Claims for RU 486/PG Abortionbreeze
Page 54 and 55: Claims for RU 486/PG Abortion18 per
Page 56 and 57: Claims for RU 486/PG Abortion1. RU
Page 58 and 59: Claims for RU 486/PG AbortionRU 486
Page 60 and 61: Claims for RU 486/PG Abortionwider
Page 62 and 63: Claims for RU 486/PG Abortionmedica
Page 64 and 65: Claims for RU 486/PG Abortionreligi
Page 66 and 67: What Is RU 486 and How Does It Work
Page 90 and 91: The Role of Prostaglandins: Known a
Page 122 and 123: ConclusionInstead, Baulieu uses the
Page 124 and 125: Conclusionintervention. Thus, RU 48
Page 126 and 127: Conclusionbetween population contro
Page 128 and 129: ConclusionThis article, appearing i
Page 130 and 131: Conclusion‘a whole net of relatio
Page 132 and 133: ENDNOTESChapter One1The paten t lic
Page 134 and 135: Endnotes12The Journal Officiel publ
Page 136 and 137: Endnotesin Gynecology and Obstetric
Page 138 and 139: Endnotesof menses. On the third day
Page 140 and 141: EndnotesAnother such example is the
Page 142 and 143: 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
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