Failed medical termination of twin pregnancy with mifepristone

Medical Abortion for a Twin Pregnancy

It is not an uncommon experience that despite taking all the contraceptive measures, one ends up getting pregnant. And because the decision to get pregnant (or not) is a very crucial one, the wrong timing can cause a woman much stress. In such a situation, she can either decide to continue the pregnancy, or she may decide to abort. In the latter condition, having sound knowledge of abortion techniques is of utmost importance.

Medical abortion

Medical abortion, also known as the abortion pill is one of the two legal types of abortion available. The other method is known as the surgical or in-clinic abortion technique. Now, the type of technique one can choose mainly depends on which trimester they’re in. The earlier the pregnancy stage you are in, the more choices you will have. Generally, medical abortion is the preferred option for many women because of reasons like secrecy/ privacy, lower cost, etc. However, abortion pills can only be taken by women who are in their first trimester. The first ten weeks of pregnancy are the safest for administering an abortion pill but one can take it till the 16th week. However, abortion after the 10th week sometimes requires the use of vacuum aspiration as well. 

Is medical abortion suitable for ending a twin pregnancy?

As per the studies that have been conducted so far, a twin gestation is just as suitable to obtain this treatment as is a singleton pregnancy. The twin pregnancy condition is not a contraindication and so, the results of using an abortion pill will be the same for a single and twin pregnancy. Although the study was not exclusively conducted on women having twin pregnancies, the results obtained showed no significant variation from the women with singleton pregnancies. Neither the complete termination of pregnancy nor the pain and bleeding data differed much for both the groups. This indicates that medical abortion is a safe and desirable option for women with a twin pregnancy. It is also noteworthy that the number of pills administered also doesn’t need to be increased in the case of twin pregnancy. 


Medical termination of pregnancy using the MTP kit is the easiest and safest way to get a self-abortion. Though the name ‘abortion pill’ suggests that there is only a single pill, the kit actually includes two pills: one RU-486 (mifepristone) and one Cytotec 200 mcg (misoprostol). Many people tend to confuse the ‘morning-after pill’ or Plan B with the abortion pill but these two are designed for separate purposes. Women within 63 days of pregnancy can use the kit. You first have to orally take the mifepristone pill. It works as antiprogestin, that is it blocks the production of progesterone (aka pregnancy hormone) and causes disintegration of the uterine lining. This results in detachment of the embryo/ fetus from the womb and terminates the pregnancy. Next, you have to take the misoprostol pill after about one to two days of taking the first pill. There are two ways of administering this pill, either you can take one 200 mcg pill orally or you can insert four of them in the vagina. If you decide to go for the latter option, make sure you either have a physician to do it or you know the proper sanitation rules to prevent any infection. Misoprostol will cause rapid contractions in the uterus which will force out the already shed uterine lining along with the discarded embryo/ fetus. You will experience blood flow and cramps, almost like having a heavy menstrual blood flow. You might also feel a little dizzy and can have a moderate fever for a couple of days. The abortion should be completed within 4 to 5 hours, however, sometimes it may take up to 1 or 2 days. Your normal menstrual cycle should be restored in about a month or 6 weeks. In case the abortion is not completed, your doctor will use vacuum aspiration to achieve the desired result.

Who cannot have a medical abortion?

There are some conditions that restrict the use of the MTP Kit, so it’s necessary for you to make sure you do not have any of the below health issues-

  • Any genetic disease.
  • If you take corticosteroids for some condition.
  • Bleeding disorders (or take anticoagulants).
  • Any allergy.
  • Any condition related to the adrenal gland.
  • If you had an ectopic pregnancy in the past.
  • If it’s a molar pregnancy (abnormal placental development). 

If you are breastfeeding, you should not take the pills. Also, if you use an intrauterine device for contraception or have RH negative blood group, you should let your doctor know so that they can take necessary care before administering the abortion pill. Lastly, make sure you can easily access a clinic in case of any emergency.

Medical abortion is a highly safe and effective way to end unwanted pregnancies for women. Whether you have a singleton or twin pregnancy, you can administer the abortion pills. It is advisable to be under the supervision of a doctor so that in case of any side effects, they can help you. Lastly, know the abortion laws of your country and state before you decide to get the abortion done. 

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