Mifepristone and Ectopic Pregnancy

Mifepristone involves one or two doctor visits.  During the initial visit the doctor will conduct a physical exam to determine whether or not that you are pregnant.  During this exam the doctor is supposed to be looking for signs of an ectopic pregnancy.[1]  A pregnancy test can tell that you are pregnant, but not where you are pregnant.[2] 

1.5% to 2% of pregnancies are ectopic.  Ectopic pregnancies are fatal 0.5 out of 1000 pregnancies. These account for 6% of all maternal deaths.  Most of these deaths could be prevented through early diagnosis and treatment.[3]  This diagnosis is supposed to be near the top of the doctor's priorities.  The FDA report notes the following.

Administration of mifepristone and misoprostol is contraindicated in patients with confirmed or suspected ectopic pregnancy (a pregnancy outside the uterus).[4]

A "contraindication" literally means "against an indication".[5] The FDA forbids use of mifepristone to be prescribed to a woman with a confirmed or suspected ectopic pregnancy.  The mifepristone will only work on uterine pregnancies.

The FDA documents several cases among the 1,520,000 women where the ectopic pregnancy was not found by the doctor.  Two women died when their ectopic pregnancies ruptured.  Another 58 women had their ectopic pregnancies missed and some of these women had to be hospitalized.

These could have been avoided if the recommended ultrasound had been used.