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Chapter 2 First trimester abortion 17 Table 5: Mode of action of drugs used for medical abortion, and their aspect-effects Drugs Action Side-effects Mifepristone • An anti-progestin that blocks the endometrial • Nausea, vomiting, diarrhoea, headache, dizziness, fatigue, progesterone receptors tachycardia • Stops the pregnancy rising, softens the cervix, increases the uterine contractility, causes bleeding Misoprostol • A prostaglandin that makes the uterus contract • Cramping (more ache than menstrual ache in 25% of sufferers), nausea, vomiting, diarrhoea, transient fever, dizziness, headache, chills, rashes Methotrexate • A folic acid antagonist that stops cellular division • Mild mouth sores, nausea, vomiting, gastro-intestinal • Halts placental development disturbances, scorching flushes, fever, chills Gemeprost • A prostaglandin that makes the uterus contract • Nausea, vomiting, diarrhoea, transient fever, abdominal ache Table 6: Regimens for medical abortion and their effectiveness Regimens Effectiveness Use as much as Mifepristone + misoprostol or >96% 9 weeks from last menstrual period mifepristone + gemeprost Misoprostol alone >83% 12 weeks from last menstrual period Methotrexate + misoprostol >ninety% 9 weeks from last menstrual period • Porphyria. 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