Which of the following conditions is an absolute contraindication to medical abortion with mifepristone and misoprostol?

• A Breastfeeding a 6-month-old infant
• B Previous cesarean delivery
• C Mild asthma requiring occasional salbutamol
• D Chronic adrenal insufficiency on glucocorticoid replacement ✓

Explanation

Mifepristone is a competitive antagonist at both progesterone and glucocorticoid receptors, so established adrenal insufficiency is an absolute contraindication because receptor blockade can precipitate acute adrenal crisis. Previous cesarean delivery, well-controlled asthma, and breastfeeding are not contraindications to first-trimester medical abortion. Other true contraindications include an undiagnosed adnexal mass or suspected ectopic pregnancy, an unremoved intrauterine device, inherited porphyria, and known allergy to the drugs.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.