Misoprostol for the termination of pregnancy with a live fetus at 13 to 26 weeks

Ho, P.C.; Blumenthal, P.D.; Gemzell-Danielsson, K.; Gómez Ponce de León, R.; Mittal, S.; Tang, O.S.

doi:10.1016/j.ijgo.2007.09.007

« Previous Next »International Journal of Gynecology & Obstetrics
Volume 99, Supplement 2 , Pages S178-S181, December 2007

Misoprostol for the termination of pregnancy with a live fetus at 13 to 26 weeks

P.C. Ho
- Department of Obstetrics and Gynaecology, University of Hong Kong, Hong Kong Special Administrative Region, China
- Corresponding author. Department of Obstetrics and Gynaecology, 6/F., Professorial Block, Queen Mary Hospital, Pokfulam Road, Hong Kong Special Administrative Region, China. Tel.: +852 28554260; fax: +852 28550947.
P.D. Blumenthal
- Department of Obstetrics and Gynecology, Stanford University, Stanford, USA
K. Gemzell-Danielsson
- Department of Woman and Child Health, Division for Obstetrics and Gynaecology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
R. Gómez Ponce de León
- Ipas and School of Public Health, UNC at Chapel Hill, Chapel Hill, NC, USA
S. Mittal
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
O.S. Tang
- Department of Obstetrics and Gynaecology, University of Hong Kong, Hong Kong Special Administrative Region, China

published online 04 October 2007.

Recommended Dosage

13–22 weeks: vaginal misoprostol 400 μg every 3 hours (max. 5 doses)

Abstract

A combination of mifepristone and misoprostol is the regimen of choice for termination of pregnancy between 13 to 26 weeks. In many countries, mifepristone is still not available, and misoprostol has to be used alone. Many misoprostol-alone regimens have been reported in the literature with apparently good results. Most of the trials were conducted in pregnancies between 13 and 22 weeks. For this gestational period, we recommend the regimen of 400 μg of vaginal misoprostol every 3 h up to 5 doses, as it appears to be effective without excessive side effects or complications. There is inadequate data to recommend a regimen for the gestational period of 23 to 26 weeks but it is advisable to reduce the dose and frequency of administration of misoprostol. Common side effects of misoprostol-induced termination of pregnancy include gastrointestinal side effects, abdominal cramps, bleeding, fever and chills. Complications may include infection or rarely rupture of uterus.

Keywords: Misoprostol, Termination of pregnancy, Second trimester