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Dosage Guidelines: Misoprostol in Obstetrics and Gynaecology

This document provides dosage guidelines for the use of misoprostol in obstetrics and gynecology for various indications. It lists the indication, dosage, and any relevant notes. The indications include induced abortion in the first trimester using 800mcg doses vaginally or sublingually, missed or incomplete abortion in the first trimester using 600-800mcg doses, cervical ripening using 400mcg doses, induced abortion or interruption of pregnancy in the second trimester using 400mcg doses, intrauterine fetal death using 100-200mcg doses depending on gestational age, induction of labour using 25mcg doses, postpartum hemorrhage prophylaxis using a 600mcg single oral dose

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Florantia Setya Nugroho
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198 views1 page

Dosage Guidelines: Misoprostol in Obstetrics and Gynaecology

This document provides dosage guidelines for the use of misoprostol in obstetrics and gynecology for various indications. It lists the indication, dosage, and any relevant notes. The indications include induced abortion in the first trimester using 800mcg doses vaginally or sublingually, missed or incomplete abortion in the first trimester using 600-800mcg doses, cervical ripening using 400mcg doses, induced abortion or interruption of pregnancy in the second trimester using 400mcg doses, intrauterine fetal death using 100-200mcg doses depending on gestational age, induction of labour using 25mcg doses, postpartum hemorrhage prophylaxis using a 600mcg single oral dose

Uploaded by

Florantia Setya Nugroho
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Misoprostol in obstetrics and gynaecology

Dosage Guidelines
INDICATION DOSAGE NOTES
Induced abortion 1 800mcg vaginally or sublingual 3-hrly Ideally used 48h after mifepristone 200mg
(1st Trimester) (max x3 within 12 hrs)a

Missed abortion 800mcg vaginally 3-hrly (max x2) or Give 2 doses and leave to work for
(1st Trimester) sublingual 600mcg 3-hourly (max x2)b 1-2 weeks (unless heavy bleeding or
infection)

Incomplete abortion 600mcg orally single dosea or 400mcg Leave to work for 2 weeks (unless heavy
2,3
(1st Trimester) sublingual single dosea bleeding or infection)

Cervical ripening 400mcg vaginally 3-hrs or sublingually 2-3 Use for insertion of intrauterine device,
pre-instrumentation hrs before procedurea surgical termination of pregnancy,
(1st Trimester) dilatation and curettage, hysteroscopy

Induced abortion 400mcg vaginally or sublingually 3-hrly Most effective when used 48h after
1,4
/Interruption of (max x5)a mifepristone 200mg.
pregnancy
(2nd Trimester)

Intrauterine fetal ntrauterine fetal death4:13-17 wks: Reduce doses in women with previous
death 200mcg vaginally 6-hrly (max x4)c. caesarean section.
Intrauterine fetal death4:18-26 wks:
100mcg vaginally 6-hrly (max x4)c. For fetal death in the third trimester see
Induction of Labour below.

Induction of labour 25mcg vaginally 6-hrly or 25 mcg orally Do not use if previous caesarean section.
2,5 2-hrlyd Instructions on preparing the oral solution
can be found here.

PPH prophylaxis 600mcg orally single dosee Not as effective as oxytocin.


2 Exclude second twin before
administration.

PPH treatment 800mcg sublingually single dosef

Notes References
1. Only use where legal and with mifepristone, where available a) WHO/RHR. Safe abortion: technical and policy guidance for health
2. Included in the WHO Model List of Essential Medicines systems (2nd edition), 2012
3. Leave to work for 1-2 weeks unless excessive bleeding or infection b) Gemzell-Danielsson et al. IJGO, 2007
4. Halve dose if previous caesarian section or uterine scar c) Gomez Ponce de Leon et al. IJGO,2007
5. Make sure you use the correct dosage overdose can lead to d) WHO recommendations for induction of labour, 2011
complications. Do not use if previous caesarian section. e) FIGO Guidelines: Prevention of PPH with misoprostol, 2012
f) FIGO Guidelines: Treatment of PPH with misoprostol, 2012

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