Misoprostol Resources
Title: Misoprostol for Treatment of Incomplete
Abortion: An Introductory Guidebook
Authors: Gynuity Health Projects
Date: 2009
Description: This resource is for clinicians and women’s health
advocates. Misoprostol has many
advantages in low-resource settings – it is inexpensive, widely available,
thermostable, and offers a low-tech, non-invasive method of uterine evacuation.
Based on current scientific evidence, the guidebook offers detailed information
about misoprostol for this indication including: efficacy, safety and
acceptability; eligibility criteria and precautions; dosing, timing and routes
of administration; visit schedule and management of complications; counseling
and information provision; integration of misoprostol into existing PAC
services. This document is available in additional languages on Gynuity's website.
Title: Application to WHO Essential Medicines List
Authors: Gynuity Health Projects
Organization: WHO
Date: 2008
Description: The World Health Organization has included misoprostol for treatment of incomplete abortion and miscarriage in its Model List of Essential Medicines (EML), which serves as a guide for development of national and institutional essential medicine lists. Gynuity Health Projects submitted the application to WHO based on strong evidence for misoprostol’s safety and efficacy in the treatment of incomplete abortion and miscarriage; a number of other agencies submitted letters in support of the application. Over a dozen randomized and comparative clinical trials have been carried out to date; the most recent showed that misoprostol has a 90-100% success rate for this indication. Use of misoprostol for uterine evacuation provides an alternative to surgical treatment, which can be of poor quality or limited accessibility in low-resource settings. Misoprostol is safe and inexpensive, and is provided in a simple, stable, tablet form. Over the past 30 years, the EML has led to worldwide acceptance of essential medicines as a way to encourage health equity. The inclusion of misoprostol in the EML may improve access to the medication where the need for it is greatest.
Title: ACOG Committee Opinion: Misoprostol for Postabortion Care
Authors: American College of Obstetricians and Gynecologists, Committee on International Affairs
Organization: ACOG Committee Opinion Number 427, February 2009
Date: 2009
Description: The ACOG Committee on International Affairs released their opinion on the use of misoprostol for postabortion care. They note that there is increasing evidence that misoprostol is a safe, effective, and acceptable method to achieve uterine evacuation for women needing postabortion care. Misoprostol must be readily available especially for women who do not otherwise have access to postabortion care. Nurses and midwives can safely provide first-line postabortion care services, including in outpatient settings, provided they receive appropriate training and support.
Title: Instructions for Use: Misoprostol for Treatment of Incomplete Abortion and Miscarriage
Authors: Gynuity Health Projects, Reproductive Health Technologies Project
Organization: Gynuity
Date: 2008
Description: Gynuity Health Projects and Reproductive Health Technologies Project convened an expert meeting looking at the use of misoprostol for incomplete abortion and miscarriage in 2004. Professionals with epidemiological, clinical and programmatic expertise reached consensus on the appropriate use of misoprostol based on the best current information. The results can be found in a brochure called “Instructions for Use (IFU).” The information in this document may serve as a basis for the development of clinical practice guidelines and patient and provider education materials. The brochure was updated in June, 2008 based on new information and research developments.
Also available in Spanish, Turkish, French, Russian, Arabic, Portuguese
Title: Treatment of incomplete abortion and miscarriage with misoprostol
Authors: J. Blum, B. Winikoff, K. Gemzell-Danielsson, P.C. Ho, R. Schiavon, A. Weeks
Organization: International Journal of Gynecology and Obstetrics
Date: 2007
Description: A literature review was conducted to determine whether misoprostol is an effective treatment for incomplete abortion and, if so, to recommend an appropriate regimen. All English language articles published before October 2007 using misoprostol in at least one of the study arms were reviewed to determine the efficacy of misoprostol when used to treat incomplete abortion in the first trimester. All available unpublished data previously presented at international scientific meetings were also reviewed. Sufficient evidence was found in support of misoprostol as a safe and effective means of non-surgical uterine evacuation. A single dose of misoprostol taken orally is recommended for treatment of incomplete abortion in women presenting with a uterine size equivalent to 12 weeks of gestation.
Title: Misoprostol in Obstetrics and Gynaecology (website)
Authors: Weeks, Fiala, and others, including experts convened by WHO
Organization: Misoprostol in Obstetrics and Gynaecology
Description: This website provides the dosage guidelines produced by the expert group convened by WHO in Bellagio in February 2007 along with extensive resources on availability, off-label use, dangers, etc. The bibliography section includes close to 2,000 articles and resources related to misoprostol.
Also available in Dutch and Spanish
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