Which of the following is an absolute contraindication to the administration of mifepristone for medical abortion?
- A Previous caesarean delivery
- B Chronic adrenal insufficiency ✓
- C Age above 35 years
- D Body mass index above 30 kg/m2
Correct answer: B. Chronic adrenal insufficiency
Explanation
Mifepristone is a competitive antagonist at both progesterone and glucocorticoid receptors, so it blocks cortisol action at the adrenal receptor level. Chronic adrenal insufficiency, current long-term systemic corticosteroid therapy, known coagulopathy or anticoagulant use, and inherited porphyria are absolute contraindications. Previous caesarean delivery, advanced maternal age and obesity are not contraindications to medical abortion, although obesity may reduce efficacy slightly and warrants appropriate counselling.
Reference: Katzung Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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