How Do Abortifacients Work?

Abortifacients are medications administered to terminate a pregnancy, or induce labor and childbirth, and control postpartum uterine bleeding. Abortifacients stimulate the uterine muscle wall (myometrium) to contract and the cervical opening to soften and dilate.

Abortifacients are synthetic forms of prostaglandin, a naturally occurring compound that promotes uterine contraction. Abortifacients promote labor-like contractions facilitating childbirth, and in the case of abortion, the expulsion of the placenta and its contents. Postpartum, the myometrial contractions control the bleeding at the placentation site.

Abortifacients may be administered through the following routes:

• Intramuscular (IM) injections into the muscle
• Vaginal insert or suppository
• Endocervical gel applied into the cervical canal

Abortifacients are approved by the FDA for use in:

• Pregnancy termination between the 13th and 20th weeks of gestation
• Refractory postpartum uterine bleeding
• Cervical ripening or softening and dilation of the cervix in pregnant women who require labor induction at full term or near term

Side effects of abortifacients may include the following:

Intramuscular injections

• Nausea
• Vomiting
• Diarrhea
• Nervousness
• Epistaxis (nasal bleeding)
• Sleep disorder/disturbance
• Hyperthermia (high body temperature)
• Flushing
• Diaphoresis (excessive sweating)
• Asthma
• Wheezing
• Coughing
• Bronchospasm
• Dyspnea (shortness of breath)
• Hyperventilation (rapid breathing)
• Pulmonary edema
• Respiratory distress
• Upper respiratory tract infection
• Chest pain
• Hypertension (high blood pressure)
• Faintness
• Vasovagal syndrome (sudden drop in heart rate and blood pressure)
• Syncope (fainting)
• Palpitation
• Tachycardia (rapid heartbeat)
• Chest tightness
• Anxiety
• Chills/shivering
• Dizziness
• Drowsiness
• Dystonia (movement disorder)
• Headache
• Lethargy
• Lightheadedness
• Nervousness
• Vertigo
• Rash
• Breast tenderness
• Dysmenorrhea-like pain
• Endometritis (inflammation of the endometrium, the inner lining of the uterus)
• Hot flashes
• Thyroid storm
• Gagging/retching
• Dry throat
• Choking sensation
• Thirst
• Taste alterations
• Perforated uterus
• Posterior cervical perforation
• Urinary tract infection
• Excessive uterine bleeding
• Uterine rupture
• Uterine sacculation (sac formation)
• Injection site pain
• Backache
• Leg cramps
• Muscular pain
• Paresthesia (abnormal skin sensation)
• Torticollis (neck muscle contraction that causes the head to twist to one side)
• Weakness
• Blurred vision
• Eye pain
• Eyelid twitching
• Tinnitus (ringing in the ears)
• Hiccups
• Retained placental fragment
• Septic shock

Vaginal insert

• Hypertonic uterine dysfunction (excessively frequent uterine contractions) with or without fetal distress
• Hypotension (low blood pressure)
• Uterine rupture
• Postpartum disseminated intravascular coagulation

Endocervical gel

• Abnormal uterine contractions
• Gastrointestinal (GI) upset
• Warm feeling in vagina
• Back pain
• Fever/high temperature
• Amnionitis (infection in the amniotic sac/uterus)
• Premature rupture of membranes
• Uterine rupture
• Postpartum disseminated intravascular coagulation

Vaginal suppository

• Vomiting
• Diarrhea
• Nausea
• Fever
• Chills/shivering
• Headache
• Backache
• Joint inflammation and pain
• Chest pain
• Chest tightness
• Syncope (fainting)
• Arrhythmia (irregular heart rhythm)
• Myocardial infarction (heart attack) in women with a history of cardiovascular disease
• Dyspnea (shortness of breath)
• Wheezing
• Coughing
• Pharyngitis/laryngitis (throat inflammation)
• Skin discoloration
• Endometritis (inflammation of the endometrium, the inner lining of the uterus)
• Uterine rupture
• Breast tenderness
• Dehydration
• Hot flashes
• Dizziness
• Muscle pain and cramps
• Vaginitis (inflammation of the vagina)
• Vulvitis (inflammation of the vulva)
• Urine retention
• Paresthesia (abnormal skin sensation)
• Stiff neck
• Tremor
• Hearing impairment
• Eye pain
• Blurred vision
• Diaphoresis (excessive sweating)
• Anaphylactic reaction (severe allergic reaction including shock)

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with travel medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of abortifacient drugs include:

• carboprost tromethamine
• Cervidil
• dinoprostone
• Hemabate
• Prepidil
• Prostaglandin E2
• Prostin E2