LYCOS RETRIEVER 
Mifepristone: Pregnancies
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Mifepristone is a synthetic steroid with an antiprogestational action as a result of competition with progesterone at the progesterone receptors. In women at doses of greater than or equal to 1mg/kg, mifepristone antagonises the endometrial and myometrial effects of progesterone. In pregnancy it sensitises the myometrium to the contraction-inducing action of prostaglandin. It is an abortifacient. It does not bind to mineralocorticoid receptors; therefore the risk of acute adrenal failure during mifepristone intake is negligible. It binds to the glucocorticoid receptors.
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Mifepristone is a steroid compound that has antiglucocorticoid and antiprogesterone properties. It increases uterine activity and causes cervical effacement and dilation for pregnancy termination.6–11 There are few studies on mifepristone for cervical ripening and labor induction in term pregnancies.12–15 Frydman et al12 studied 120 women at term who received 200 mg mifepristone or placebo for 2 consecutive days of a 4-day observation period. More women had spontaneous labor and fewer needed cervical ripening with prostaglandin in the mifepristone-treated group than in the placebo group. Similar results were reported in 93 women with post-term pregnancies who were given mifepristone or placebo. Mifepristone produced greater cervical ripening and reduced time to delivery compared with placebo.14
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Mifepristone, a synthetic steroid, competitively binds to the intracellular progesterone receptor, blocking the effects of progesterone. When used for the termination of pregnancy, this leads to contraction-inducing activity in the myometrium. In the absence of progesterone, mifepristone acts as a partial progesterone agonist. Mifepristone ... has weak antiglucocorticoid and antiandrogenic properties; it blocks the feedback effect of cortisol on corticotropin secretion.
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Mifepristone blocks the hormone progesterone needed to maintain the pregnancy. Because this hormone is blocked, the uterine lining begins to shed, the cervix begins to soften and bleeding may occur. With the later addition of the second medication, misoprostol, the uterus contracts and the pregnancy is usually expelled within 6 to 8 hours.
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Mifepristone is contraindicated in cases of ectopic pregnancy, adrenal failure, hemorrhagic disorders, anticoagulant or corticosteroid therapy. Side effects include an expected amount of abdominal pain and vaginal bleeding... there can be nausea, vomiting and fever. Incomplete termination would require further intervention, such as vacuum aspiration. Mifepristone blocks the progesterone receptor, leading to changes in the endometrial blood supply. In contrast, methotrexate inhibits DNA synthesis and primarily affects rapidly dividing cells. In early pregnancy methotrexate interferes with the process of implantation through its effect on trophoblastic tissue.
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Mifepristone is used alone or in combination with misoprostol (Cytotec) to end an early pregnancy. Early pregnancy means it has been 49 days or less since your last menstrual period began. Mifepristone is in a class of medications called antiprogestational steroids. It works by blocking the activity of progesterone, a substance your body makes to help continue pregnancy.
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