Name of the Procedure:

• Common Name: Mifepristone
• Technical Terms: Mifepristone, oral, 200 mg (HCPCS Code S0190)

Summary

Mifepristone is an oral medication used for medical termination of a pregnancy. It works by blocking the hormone progesterone, which is necessary for the pregnancy to continue.

Purpose

• Medical Conditions: Termination of an early pregnancy (up to 10 weeks gestation).
• Goals/Outcomes: To safely end an early pregnancy.

Indications

• Women seeking medical termination of a pregnancy within 10 weeks of gestation.
• Confirmed intrauterine pregnancy through ultrasound or physical examination.

Preparation

• Pre-procedure Instructions:
  • Consultation with a healthcare provider to discuss medical history, procedure, risks, and benefits.
  • Possible ultrasound to confirm the duration and location of the pregnancy.
• Diagnostic Tests:
  • Blood tests to determine pregnancy hormone levels and Rh factor.
  • Confirmatory ultrasound, if necessary.

Procedure Description

• Step-by-Step:
  1. The patient takes an oral dose of 200 mg of mifepristone in the presence of a healthcare provider.
  2. 24-48 hours later, the patient takes a second medication, misoprostol, either orally or vaginally, as directed.
• Tools/Equipment: Oral tablets.
• Anesthesia/Sedation: Not required.

Duration

• The initial dose appointment typically lasts 1 hour.
• Follow-up dose to be taken 24-48 hours later, which can often be done at home.

Setting

• The initial dose is administered in a clinical setting (e.g., clinic, doctor's office).
• The second dose can be taken at home.

Personnel

• Physician or nurse practitioner.
• Nursing staff for support and follow-up care.

Risks and Complications

• Common Risks: Nausea, vomiting, heavy bleeding, abdominal pain, diarrhea.
• Rare Risks: Incomplete abortion requiring surgical intervention, infection, severe allergic reaction.

Benefits

• Non-surgical termination of early pregnancy.
• High success rate (up to 98% effective if taken within the recommended gestation period).

Recovery

• Post-procedure Care:
  • Follow-up appointment within 1-2 weeks to ensure the procedure was complete.
  • Instructions for managing pain and bleeding, recognizing signs of complications.
• Expected Recovery Time: Most symptoms resolve within a week, though bleeding can last longer.
• Restrictions/Follow-up: Avoid heavy lifting and sexual intercourse until follow-up confirms completion.

Alternatives

• Surgical Termination:
  • Vacuum aspiration or dilation and curettage (D&C).
• Pros/Cons: Surgery is quicker but more invasive; mifepristone allows for a more private, less invasive experience.

Patient Experience

• During Procedure: Mifepristone is taken orally, typically causing no immediate discomfort.
• After Procedure: Cramping and bleeding similar to a heavy period, with pain management through standard over-the-counter medications like ibuprofen. Comfort measures such as heating pads may help alleviate cramps.