Dr. Joel Kompanietz, a practicing Ob/Gyn in France, offers his experience using RU 486.

Dr Joel Kompanietz, MD

Centre Hospitalier BP 538
81207 Mazamet cedex - France
Email: joel@horus-medical.fr

RU 486, called Myfegine in France, seems to be a good product. In abortion, we use it no later than 7 weeks of amenorhea, so women will have to hurry for consultation or to have surgery.
Success rate is 95-98 %:
If the RU 486 abortion sequence fails, surgery is imperative due to possible malformative effects.
Before using RU 486, you must have an echography to confirm the intra-uterine localisation of the pregnancy. RU 486 is not advised for extra-uterine pregnancies.

• administer orally - 3 cp. of RU 486
• wait 48 hours
• administer orally - 2 cp. of misoprostol
• Monitor the patient for a few hours, after administering the misoprostol, for possible vomiting and low blood pressure. We keep patients under observation 4 hours before they are sent home.
  There are two ways to examine for results: echography or HCG. I use HCG, as echography may not show anything this early in pregnancy.
  Patients over the age of 35 or that smoke can not use RU 486 - one death from cardio-vascular complications has been reported. Women under 35 years old must stop smoking during the RU 486 abortion sequence.
  
  In cases when the fetus has died in the womb
• Administer 3 cp a day for 2 days
• If no signs of labor in 72 hours use the prostaglandins. Adhere to standard care of prostaglandins usage.
• NOTE: the use of RU 486 decreases, by 60 %, the rate of prostaglandins required to get expulsion.
  
  In medical pregnancy interruption (later in pregnancy than voluntary abortions):
• Administer 3 cp of RU 486
• 36 to 48 hours later administer usual prostaglandins.
• NOTE: RU 486 decreases the rate of prostaglandins needed.
  
  For additional reference see:
  New England Journal of Medicine - April 13, 1995 -- Volume 332, Number 15: Induction of Abortion with Mifepristone (RU 486) and Oral or Vaginal Misoprostol.
  Hazem El-Refaey, Dhamnasekar Rajasekar, Mona Abdalla, Lynda Calder, Allan Templeton.