RU486 Failure: Causes and Implications for Women's Health

Failure after taking RU486?

1.
What are the common reasons for the failure of RU486? Is there a relationship between taking the medication multiple times and experiencing a medical abortion? (Including this time, it will be the fourth time, and I have had one child.)
2.
On February 24, I took the first dose in front of the clinic staff.
After returning home, I noticed slight bleeding on the first and second days.
On the third day, February 26, I took the second dose (three tablets) and only experienced mild discomfort in the lower abdomen.
I went to the bathroom (similar to having diarrhea) twice, but did not have the severe abdominal pain I experienced previously, and I started to pass some blood.
On February 27, during a follow-up visit, it was found that the abortion was not complete, and the embryo was still clearly visible.
The doctor prescribed three more tablets along with one vaginal suppository.
After returning home, I experienced vomiting and continued mild discomfort in the lower abdomen, but no severe pain.
When I changed my sanitary pad, I noticed that the bleeding seemed to have either stopped or decreased.
Does this mean that the procedure has failed? Because I did not experience the same level of bleeding as I did after taking the medication the first time.

Le, 20~29 year old female. Ask Date: 2018/02/27

Dr. Huang Jianzhong reply Obstetrics and Gynecology

1.
What are the common reasons for the failure of RU486? Is there a relationship between taking the medication multiple times and medical abortion? (Including this time, I have one child.) Answer: There are many reasons for failure, but taking the medication multiple times is not related to medical abortion.
2.
On February 24, I took the first dose in front of the clinic staff, and I noticed slight bleeding on the first and second days after returning home.
On the third day, February 26, I took the second dose (three tablets) and only experienced mild lower abdominal discomfort.
I went to the bathroom (similar to having diarrhea) twice, but did not have the severe abdominal pain I experienced previously, and I started to pass blood.
On February 27, during my follow-up visit, it was found that the abortion was incomplete, and the embryo was still clearly visible.
The doctor prescribed three additional tablets along with one vaginal suppository.
After returning home, I experienced vomiting and continued mild lower abdominal discomfort, but it was not severe.
When I changed my sanitary pad, I noticed that the bleeding seemed to have either stopped or decreased.
Does this mean it has failed? Because I did not experience the same level of bleeding as when I took the medication the first time.
Answer: On February 24, I took the first dose (RU486) in front of the clinic staff, and on February 26, I took the second dose (three Cytotec tablets).
On February 27, during my follow-up visit, it was found that the abortion was incomplete, and the embryo was still clearly visible.
The doctor prescribed three additional tablets along with one vaginal suppository (Cytotec).
This does not mean it has failed; it simply indicates an increased dosage of Cytotec.

Reply Date: 2018/02/27

More Info

RU486, also known as mifepristone, is a medication used for medical abortion, and its effectiveness can vary based on several factors. Understanding the reasons for its potential failure is crucial for women considering this option, especially in the context of repeated use and the implications for future pregnancies.

1. Causes of RU486 Failure: The failure of RU486 can occur for various reasons, including:
- Gestational Age: The medication is most effective when used early in pregnancy. If the pregnancy is beyond 10 weeks, the success rate decreases significantly.

- Dosage and Administration: The effectiveness can also depend on the correct dosage and the method of administration. For instance, if the second medication (usually misoprostol) is not taken correctly or in the right amount, it may lead to incomplete abortion.

- Individual Variability: Each woman's body responds differently to medications. Factors such as hormonal levels, uterine health, and overall health can influence how well RU486 works.

- Incomplete Abortion: In some cases, the abortion may not be complete, leading to the presence of fetal tissue in the uterus, which can require further medical intervention.

Regarding your concern about whether taking RU486 multiple times affects its efficacy: generally, repeated use of RU486 does not inherently decrease its effectiveness in subsequent abortions. However, it is essential to consult with a healthcare provider to ensure that there are no underlying health issues that could complicate the process.

2. Your Experience with RU486: Based on your description, it seems you experienced some typical side effects after taking RU486, such as slight bleeding and abdominal discomfort. The fact that you had some bleeding after the first dose is a positive sign, as it indicates that the medication is having an effect. However, the subsequent visit revealing that the abortion was incomplete suggests that the process did not fully succeed.

The presence of fetal tissue after taking RU486 can happen, and it does not necessarily mean that the medication has failed entirely. It may require additional doses of misoprostol or a follow-up procedure, such as a dilation and curettage (D&C), to ensure that the uterus is clear. The symptoms you described, such as mild pain and nausea, are common but should be monitored closely. If you experience heavy bleeding, severe pain, or signs of infection (like fever), you should seek medical attention immediately.

In summary, while RU486 is generally safe and effective, its success can be influenced by various factors, including timing, dosage, and individual health conditions. If you have concerns about future pregnancies or the implications of repeated use, it is crucial to have an open dialogue with your healthcare provider. They can provide personalized advice based on your medical history and current health status, ensuring that you make informed decisions about your reproductive health.

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