RU 486/Misoprostol (3/2+1) (Myfegine/Citotec) in Guadeloupe - abstract

Use of RU 486 as an abortifacient is legal in Guadeloupe under the French Abortion Law since June 1991. Addition of a low dose of prostaglandin is necessary to obtain satisfactory results from RU486 for termination of early pregnancy. Injections of Sulprostone (Nalador), used at first, were abandoned in July, 1992. Since September, 1992, pills of Misoprostol (Citotec) have been combined with RU 486 under a simplified protocol. This study concerns 345 cases in which RU 486/Misoprostol was used to terminate early pregnancy in Guadeloupe between September, 1992 and October, 1993 in the main city public hospital and in a private clinic, representing 84 percent of all RU 486 used in Guadeloupe during this period. Efficiency reached 95 percent, a result similar to those found in other surveys. For 22 percent of the patients, bleeding occurred 48 hours after taking RU 486, thus before taking of Misoprostol. In 68 percent of cases, bleeding occurred five hours or less after taking Misoprostol. Only 4 percent needed to take the third pill of Misoprostol. Metrorrhagia was reported for 30 percent of cases. Overall the method is efficient, simple, easy to use and does not require hospitalization. The cost is relatively low: US$50.00 for the three pills of RU 486 and US$1.00 for the three Misoprostol pills. There were no episodes of infection, accidents or trauma to the uterus, but menorrhagia was frequently seen. Based upon this experience, we believe that for termination of early pregnancy RU 486/Misoprostol is a better alternative to suction, dilatation and curettage (AU)

Contrasting challenges in the Caribbean

The 13 Commonwealth countries which make up the Caribbean Common Market, or CARICOM, are home to more than 5 million people at varying stages of development. They present a unique picture of what future population trends might be according to various assumptions about emigration and fertility. (AU)