These dosage guidelines are produced by FIGO and based on guidelines produced by WHO, FIGO and Bellagio group.
A full pictorial guide on how to safely make up a 200ml batch of a 1 microgram per ml solution of misoprostol for oral administration can be found here.
Induced abortion1 (1st Trimester) Reduce doses in women with previous caesarean section. For fetal death in the third trimester see 'Induction of Labour' below.
Induced abortion1 (1st Trimester)
Reduce doses in women with previous caesarean section.
For fetal death in the third trimester see 'Induction of Labour' below.
1. Only use where legal and with mifepristone, where available
2.Included in the WHO Model List of Essential Medicines
3. Leave to work for 1-2 weeks unless excessive bleeding or infection
4. Halve dose if previous caesarian section or uterine scar
5. Make sure you use the correct dosage - overdose can lead to
complications. Do not use if previous caesarian section.
a. WHO/RHR. Safe abortion: technical and policy guidance for health systems (2nd edition), 2012
b. Gemzell-Danielsson et al. IJGO, 2007
c. Gomez Ponce de Leon et al. IJGO,2007
d. WHO recommendations for induction of labour, 2011
e. FIGO Guidelines: Prevention of PPH with misoprostol, 2012
f. FIGO Guidelines: Treatment of PPH with misoprostol, 2012
Misoprostol is a very powerful stimulator of uterine contractions in late pregnancy and can cause fetal death and uterine rupture if used in high doses. Follow the dosage regimes carefully and do not exceed those doses.
Figure 1: Safe single doses of vaginal misoprostol for producing uterine contractions at various gestations. For the first trimester 800µcg 24 hourly can be safely used. In the second trimester 200µcg 12 hourly is a common dose, whilst beyond 24 weeks 25µcg 6 hourly is usually used. If a higher dose than this is used, then uterine hyperstimulation with uterine rupture or fetal distress might be the result