[RU 486 and induction of labor in pregnancy terminations in the third trimester of the pregnancy: a preliminary clinical study]

RU-486 was used to induce labor in 12 cases to terminate singleton pregnancies of at least 30 weeks gestational age. The fetus was living and without signs of distress on monitoring and no patient showed any sign of spontaneous labor. The average gestational age was 34.2 weeks. In 9 cases the fetus had a malformation incompatible with survival or with normal cognitive life and in the other 3 cases the extraction was necessitated by severe maternal or fetal pathology. RU-486 was administered in single doses of 400 mg/day for 2 days. In 6 cases labor began within 72 hours using only RU-486. In 4 cases labor was induced with RU-486 and Syntocinon. In 2 cases administration of RU-486 and Syntocinon failed to induce labor and a cesarean was necessary. The average delay to expulsion was 48.6 hours in the 6 patients responding to RU-486 alone. No sign of fetal distress was noted after administration of RU-486. The malformed infants all died immediately after birth as a result of their malformations. 2 of the live born infants without malformations were delivered vaginally and 1 by cesarean. 1 infant was delivered at 37 weeks due to an anti-Rh immunization. The birth weight was 3200 g the Apgar score was 10 in the 1st and 5th minute and no side effects were noted at 9 months of life. The 2nd infant was delivered at 34 weeks due to severe hypertension. Birth weight was 1500 g and the Apgar score was 9 at the 1st minute and 10 at the 5th. Cardiac sonography recorded a permeable arterial canal which was no longer noted in the 5th month when the infants health was judged normal. The infant delivered by cesarean in the 33rd week had an anti-C rhesus immunization. Birth weight was 3000 g. The Apgar score was 4 in the 1st minute and 8 in the 5th. No problems were noted at 9 months. RU-486 appears to be a useful agent for 3rd trimester therapeutic pregnancy terminations but its utility should be confirmed on a larger number of cases with well defined protocols.