US: 7th fatality [misoprostol + laminaria-related] raises concern about medical abortion perils Print E-mail
 Friday May 12, 2006

7th Death in Medical Abortion


ATLANTA, May 11 ­ Federal health authorities said Thursday that they had discovered a seventh death linked to a medical abortion, although the woman who died did not take the abortion drug RU-486.

The announcement came at a meeting of scientists from the nation's leading health agencies called by the Food and Drug Administration to discuss the safety of RU-486.

Six other women have died after taking RU-486, according to health officials. Five of the women were found to have died from an infection caused by a rare bacterium, Clostridium sordellii.

C. sordellii

The deaths, which have occurred since RU-486 was approved in 2000, have led some abortion providers to change the way they give pill-based abortions, which some experts say may make women more susceptible to infection.

But Sandra Kweder, deputy director of the F.D.A.'s office of new drugs, said that officials are increasingly asking whether other factors besides RU-486 may have played a role in the deaths.

"It's a far more complex medical and epidemiological situation than initially might have appeared to be the case," Dr. Kweder said.

Dr. L. Clifford McDonald, a medical epidemiologist at the C.D.C., said that in the latest death the woman had been given misoprostol, a drug that is commonly used in obstetrics care to induce uterine contractions. The drug was given vaginally.

The woman was also given laminaria, a drug made from sea algae that is sometimes used to dilate the cervix during surgical abortions.

Federal drug officials have only approved giving misoprostol orally, but many doctors give it vaginally. Some experts believe that giving misoprostol vaginally increases the risks of infection with Clostridium sordellii or other bacteria.

Dr. McDonald said that the two most recent deaths were caused by Clostridium perfringens, a bacterium that is related to but distinct from Clostridium sordellii.

The significance of the new information was unclear. Dr. James McGregor, a visiting professor of obstetrics and gynecology at the University of Southern California, said that because pill-based abortions appeared to be far riskier than surgical ones, clinics should "reduce or eliminate" the use of RU-486.

He added that if clinics stopped short of eliminating the use of RU-486, they should discuss the risks of pill-based abortions more clearly with patients. Monty Patterson and Dr. Didier Sicard, two fathers of women who died after taking RU-486, attended the meeting.

Mr. Patterson said that the meeting confirmed his notion that RU-486 "is not safe."

"It killed my daughter and I want it off the market," he said.

Dr. Sicard, a professor of medicine at René Descartes University in Paris, said he did not believe that the drug should be removed from the market.

"I don't want to confuse my personal grief with my professional judgment," Dr. Sicard said, "but the drug has to be given with a high degree of medical control."