European Journal of Obstetrics & Gynecology and Reproductive Biology published an article in December 2016 t report the prospective follow-up of pregnancies exposed to misoprostol during the first trimester and analyse the teratogenic risk depending on the indication for use. A study of 265 women exposed to misoprostol during the first 12 weeks of pregnancy and followed until they delivered.
The main indication for misoprostol was voluntary abortion (60.9%). Ten major malformations (5.5%) were reported and five of them were consistent with the pattern of malformations attributed to misoprostol.
The rate of malformations was higher, but not significantly, in women exposed to misoprostol for voluntary abortion (7.9%) compared with women exposed to misoprostol for other or unknown indications (3.2%).
Results confirmed a specific pattern of malformations due to misoprostol use in early pregnancy, even with low dose of misoprostol. Despite the small number of cases, we observed a higher proportion of major malformations in fetuses born to women who continued their pregnancy after a failed voluntary abortion with misoprostol.