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In 2012, the International Federation of Obstetrics and Gynecology (FIGO) produced a chart detailing recommended dosages of misoprostol when used alone, for a variety of gynecologic and obstetric indications. In light of new evidence 1-13 and through expert deliberation, this chart has now been revised and expanded (Fig. 1). Some areas were particularly challenging to develop given the limited, low-quality, or inconsistent evidence. The present commentary is intended to explain some of the changes and decisions made. | GENERAL CHANGESThe layout is now categorized vertically by gestation and horizontally by indication. Gestation is labelled and referred to as the number of weeks of gestation (<13 weeks, 13-26 weeks, and >26 weeks), with the final column being for postpartum use. However, in the case of incomplete abortion under 13 weeks, and inevitable abortion between 13-26 weeks, women should be treated on the basis of their uterine size rather than last menstrual period dating. Recommendations have been added for inevitable abortion and cervical preparation between 13 and 26 weeks, and for termination of pregnancy at more than 26 weeks. | NUMBER OF DOSESFor less than 13 weeks' gestation, we decided to recommend a fixed number of doses without specifying a maximum. This is because many early pregnancy regimens will be used on an outpatient basis, so it is useful for healthcare providers to know in advance how many doses to give the client; there is also sufficient evidence to support a fixed number of doses for use in pregnancies of less than 13 weeks' gestation, as well as evidence that it is safe to give further doses if they are required. [1][2][3][4]14 For 13-26 weeks' gestation, the notion of a maximum number of doses has been extrapolated from clinical research in which maximum doses are commonly noted not on the basis of patient safety issues or efficacy, 9 but rather as tangible endpoints. In clinical practice, however, they might not have great utility, and dosing should continue until expulsion, in the absence of rare complications. Suggesting that providers should discontinue dosing could actually increase risks, particularly when providers have few alternatives available if expulsion has not yet This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

The present comprehensive reference document was designed to enable clinicians and policy makers to quickly access and compare recommendations for the use of misoprostol in various reproductive health settings.

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This review supports the evidence that insertion of an intrauterine contraceptive within the first 48 hours of vaginal or caesarean delivery is safe. Expulsion rates should be further studied in larger randomised controlled trials.

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Analysis 13.1. Comparison 13 prostaglandin alone vs combined regimen (all), Outcome 1 failure to achieve complete abortion.... Analysis 13.2. Comparison 13 prostaglandin alone vs combined regimen (all), Outcome 2 side e ects.