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May 18, 2006
US Doctors consulting
Health-care providers must learn how to spot C. sordellii infections, which have caused deaths in U.S. women who had recently had abortions, miscarriages or given birth.
Photo courtesy of IndexOpen.

With four U.S. deaths from a rare bacterial infection after medication abortion, the Centers for Disease Control and Prevention, the Food and Drug Administration and the National Institute of Allergy and Infectious Diseases have called for more research into why the toxic bacterium has proved fatal in all postpregnancy infections.

Despite widespread media reports that focus solely on the medication abortion deaths related to the Clostridium sordelliibacterium (often referred to as C. sordellii), the infection has occurred in other circumstances and even in men. But it’s been fatal in all obstetric or gynecological-related cases; it’s killed women after childbirth, miscarriages and medication abortions.

On May 11, the agencies co-sponsored an Atlanta workshop on what they call “emerging clostridial disease.” In four of the deaths attributed to the sepsis or poisoning caused by the bacteria, the woman had recently undergone a medication abortion using Mifeprex (brand name for mifepristone) and misoprostol. Investigators found no contamination of the two drugs.  

Dr. Paul Seligman, director of the Office of Pharmacoepidemiology and Statistical Sciences in the FDA’s Center for Drug Evaluation and Research, opened the meeting. He acknowledged the lack of clarity about the relationship between medication abortion and C. sordellii. Then, he added, there’s the issue of why it appeared in a very specific area: the western United States.

While researchers can’t pinpoint why the lethal infections have occurred, there is significant evidence that the drugs used in these medication abortions are safe. Mifeprex (the brand name for mifepristone) was approved by the FDA for U.S. use in 2000, and since then, about 560,000 American women have used it. The estimated death rate from abortion is approximately 1 per 100,000 procedures after use of mifepristone and misoprostol. (By contrast, the overall death rate from pregnancy-related causes was 8.9 per 100,000 live births in 2002).

The medication abortion regimen has also been used in dozens of countries and by millions of women who ended pregnancies without incident.

Ipas Medical Director Dr. Laura Castleman attended the workshop and said: “We, too, want to know why women are dying from this infection. We believe that the scientific data proves medication abortion is a safe option for women in the United States and beyond. We’ll continue to monitor the news and research regarding medication abortion and C. sordellii, and consider what’s best for women’s health and lives.”

Among the many questions for future research is whether there’s something about a woman’s body during or after pregnancy that makes it a better host for the bacterium. At the May 11 workshop, Dr. David Soper of the Medical University of South Carolina in Charleston said the C. sordellii deaths can’t just be a simple case of mifepristone. He suggested that researchers must look at the postpartum or postpregnancy periods in general. 

But in the time it takes scientists to solve this medical mystery, there’s a need to alert all health-care providers, including general practitioners and emergency room staff, about how to spot C. sordellii infections, which don’t present obvious symptoms. And beyond early diagnosis, there’s an equally important need to develop treatments — so that when a woman contracts the C. sordellii infection after an abortion, miscarriage or labor, it’s not an automatic death sentence.

For more information, contact:
Kirsten Sherk
Senior Associate, Media Relations
e-mail: sherkk@ipas.org
phone: 919.960.5612
fax: 919.929.0258