A woman at 8 weeks gestation is being counselled for medical abortion with mifepristone and misoprostol. Which of the following is an absolute contraindication to mifepristone administration?

• A Previous lower segment caesarean section
• B Age over 35 years
• C Breastfeeding
• D Chronic adrenal failure ✓

Explanation

Chronic adrenal failure contraindicates mifepristone because its glucocorticoid receptor antagonism can precipitate acute adrenal insufficiency in patients dependent on exogenous steroids. Other absolute contraindications include confirmed ectopic pregnancy, haemorrhagic disorders, and inherited porphyria. Previous caesarean delivery is not a contraindication to first trimester medical abortion. Breastfeeding and advanced maternal age are relative considerations at most, not prohibitions, per WHO abortion care guidance.

Reference: WHO Abortion Care Guideline, 2022 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.