Misoprostol and Teratogenicity

An expert review of the teratogenicity of misoprostol was undertaken in 2002. Details of the full report are available here. The report concluded that:

“There is an association between birth defects and in utero exposure to misoprostol. It appears that the abortion process induced by misoprostol (e.g., uterine contraction and bleeding) could be causative, leading to temporary vascular disruption in the placental–fetal unit. This disruption could reduce the blood supply to the placenta and result in hypoperfusion, hypoxia, or vascular obstruction in the fetus. A wide range of defects is possible, but the most commonly cited following in utero exposure to misoprostol are equinovarus (clubfoot), cranial nerve anomalies (affecting nerves V, VI, VII, and XII), and absence of the fingers.”

“While the relative risk of malformations appears real, epidemiological studies indicate that the absolute risk (i.e., the number of cases) is low (less than 10 malformations per 1,000 births exposed to misoprostol in utero). This risk estimate ought to be clearly communicated when educating women on the risk of fetal defects following in utero exposure to misoprostol. Only with such information can women make fully informed reproductive health decisions. Similarly, this risk, like all risks, must be placed in context. For example, in low-resource settings and in countries where access to safe, legal abortion is limited, misoprostol is generally a rather safe, low-cost abortion option for women seeking to terminate a pregnancy, with fewer repercussions than unsafe abortion. In fact, the availability of misoprostol was shown to reduce morbidity associated with unsafe abortion. The potential public health benefits of this drug for women must also be weighed in the overall discussion and decision making on policy alternatives.”

Please click here to download the Teratogenicity study (Dal Pizzol 2008)

Misoprostol, like the vast majority of drugs, has potential adverse effects. The links below list the common symptom characteristics.