Non-surgical expulsion of non-viable early pregnancy: a new application of RU 486

As an alternative to dilatation and curettage or expectant management, a single oral dose of 600 mg RU 486 was given to 3 women after failure of early pregnancy after in vitro fertilization and embryo transfer (IVF- ET) or gamete intra-Fallopian transfer (GIFT). In these women when early pregnancies are lost, missed abortions may endure because of continued progesterone release by the corpus luteum causing sustained hCG production by remaining trophoblast tissue. These 3 cases experienced fetal demise at 40, 38 and 28 days gestation. RU-486 was given orally on Days 53, 55 and 45, respectively, resulting in passage of the gestational sac within 2-3 days in all cases. The women experienced light spotting for 2 days, or bleeding for 1 week. Their menses reappeared within 1 month. This non-invasive approach was welcomed by the patients as a psychological relief.