Suncoast Pinellas News
Drug Induced Abortion Death Clue Found
Scott R. Galvin/UM
Dr. David Aronoff, infectious disease researcher at the University of Michigan, using an oxygen-free "glove box" in studying the anaerobic bacterium Clostridium sordellii. The pathogen, which rarely causes serious illness in humans, has been implicated in deaths associated with a few drug-induced abortions.
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Published: June 25, 2008
The off-label administration of a drug often given along the abortion pill RU-486 and not RU-486 itself could be the cause of the infection-related deaths of a relative handful of women who were given the two-drug combination to chemically terminate a pregnancy.
The culprit, says Dr. David Aronoff, an infectious disease specialist at the University of Michigan, is the vaginal administration of the drug misoprostol. The Food and Drug Administration has approved giving Misoprostol, a synthetic form of the human immune-response repressor prostaglandin E2, in concert with RU-486, but only by mouth. Although the FDA has not evaluated the safety of vaginal administration of misoprostol, some doctors .
Based on experiments with lab animals and cell cultures, Aronoff and his colleagues concluded vaginal delivery of misoprostol suppresses the immune system so much the bacterium Clostridium sordellii, can run amok, causing a fatal case of sepsis. C. sordelli, an anaerobic, or oxygen-hating, bacterium, normally does not cause serious infections in humans.
As they report in the Journal of Immunology, the U-M researchers injected misoprostol into the uterus of lab rats and then exposed them to C. sordelli. Within four days 80 percent were dead.
The cell study suggested misoprostol weakened several key immune defenses in the reproductive tract. The drug suppressed the action of macrophages, immune cells that normally engulf and kill invading bacteria, and the action of neutrophils. It also inhibited certain other immune defenses, including the production of anti-bacterial chemicals normally made by cells lining the uterus.
Aronoff and his colleagues hope the results of their research will convince doctors to forgo vaginal administration of misoprostol.
Of the half-million drug-induced abortion using the combination of RU-486 and misoprostol, only eight were associated with deaths attributed to C. sordelli sepsis.
"Infections after medication abortions are rare, and Clostridium infections after abortion are exceedingly rare," Aronoff said, adding, "The findings should help make a safe procedure even safer."
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