Misoprostol for labour induction

Kumar, Nimisha; Haas, David M.; Weeks, Andrew

doi:10.1016/j.bpobgyn.2021.09.003

Cited by 11 publications

(13 citation statements)

References 27 publications

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“…Although it normally appears in colostrum and milk, the low levels detected suggest that a minimal amount of misoprostol could potentially be ingested by the newborn. (4) What are the adverse effects and contraindications for using misoprostol?…”

Section: What Are the Pharmacokinetic Properties Of Misoprostol?mentioning

confidence: 99%

Misoprostol use in obstetrics

2023

Rev Bras Ginecol Obstet

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Misoprostol is a prostaglandin E1 (PGE1) analogue that has been on the World Health Organization (WHO) List of Essential Medicines since 2005.• Brazil has one of the most restrictive regulations in the world related to the use of misoprostol establishing it is exclusively for hospital use with special control, and sale, purchase and advertising prohibited by law. • Misoprostol is currently the reference drug for pharmacological treatment in cases of induced abortion, both in the first trimester of pregnancy and at more advanced gestational ages. • Misoprostol is an effective medication for cervical ripening and labor induction.• Misoprostol is an essential drug for the management of postpartum hemorrhage. Recommendations• The use of misoprostol is recommended for the following situations: legal abortion, uterine evacuation due to embryonic or fetal death, cervical ripening before labor induction (uterine cervix maturation), labor induction and management of postpartum hemorrhage. • Misoprostol 800 mcg vaginally (four 200 mcg pills) is recommended for uterine evacuation in pregnancy loss up to 13 weeks. • In cervical preparation for surgical abortion at less than 13 weeks of pregnancy, the use of misoprostol 400 mcg vaginally 3-4 hours before the procedure is recommended. • The use of misoprostol alone according to the gestational age for uterine evacuation is recommended for termination of pregnancy in legal abortion. • The use of vaginal misoprostol according to the gestational age is recommended for uterine evacuation in case of fetal death: at 13-26 weeks, 200 mcg every 4-6 hours; at 27-28 weeks, 100 mcg every 4-6 hours; and over 28 weeks, 25 mcg every six hours. • The use of misoprostol at an initial dose of 25 mcg vaginally every 4-6 hours is recommended for cervical ripening and induction of labor with a live fetus in pregnancies over 26 weeks. • The use of misoprostol for cervical ripening and induction of labor with a live fetus is not recommended in women with a previous cesarean section due to the greater risk of uterine rupture. • Misoprostol is a safe and effective option for women with premature rupture of membranes and unfavorable uterine cervix, as long as they do not have contraindications for taking the medication, for example, previous cesarean section. • Rectal misoprostol 800 mcg is recommended as part of the drug treatment of postpartum hemorrhage.• In Brazil, misoprostol should be made available to all health services at all levels of care, and it is desirable that outpatient use be allowed, when indicated.

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Section: What Are the Pharmacokinetic Properties Of Misoprostol?mentioning

confidence: 99%

Misoprostol use in obstetrics

2023

Rev Bras Ginecol Obstet

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“…3 Furthermore, the use of Misoprostol for labor induction is also approved in many countries because of its affordability, molecular stability, ease of administration, and clinical efficacy. [4][5][6] It acts through its effect on the cervix as a ripening and uterotonic agent. 7 Misoprostol is known as a safe drug with very few side effects.…”

Section: Introductionmentioning

confidence: 99%

Reactions to Misoprostol: A Case Report

Salari,

Pourrajabi,

Karami

et al. 2023

Clin Med Insights Case Rep

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Background: Most of abortions occur before the 13th week of pregnancy. Nowadays, non-surgical approaches for evacuation of uterine have been replaced with surgical ones due to the reduction in bleeding, fewer complications, ease of management, and cost-effectiveness. Misoprostol is a prostaglandin E1 analog that is used for labor induction. It is known as a safe drug with very few side effects. Case Presentation: A 29-year-old woman with the gestational age of 11 weeks and 6 days with a diagnosis of cystic hygroma introduced herself to the labor ward. At the time of hospitalization, the patient was conscious. The heart sounds were normal. A vaginal exam indicated no pathological findings. Totally, she received 1000 mg of Misoprostol. Approximately, 2 hours after the last placement of Misoprostol, the patient developed bending and mild cyanosis of fingers and showed tachycardia with a pulse rate of 140 beats/min. Her O2 saturation decreased to 78%. At this time, the patient had a successful miscarriage. Echocardiography showed an ejection fraction of 55% and normal right ventricular size. The electrocardiogram showed sinus tachycardia. Therefore, she was sent to CCU with a possible diagnosis of embolism. The cardiologist administered a heparin drip of 5000-unit IV stat, and 1000 unit/h heparin and asked for a D-Dimer test. However, the laboratory reported that the patient’s blood sample was hemolyzed and they could only check her hemoglobin which was 4 g/dl. Immediately, the heparin drip was held and the patient received 3 packed cells. Her Hb was 6.5 g/dl. 12 hours later she showed tachycardia, and her O2 saturation reduced to 70%. She lost her consciousness. Nearly 40 minutes later, she had cardiorespiratory arrest and CPR wasn’t successful and she died. Conclusions: In Conclusion, even a frequently used drug such as Misoprostol can cause life-threatening side effects, leading to emergent situations.

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“…Misoprostol is a prostaglandin E1 analogue that is used to stimulate uterine contractions, cervical dilation, and increased uterine tone. Misoprostol improved cervical ripening and dilation before minimally invasive gynaecological treatments such uterine evacuation and hysteroscopy, which could help in reducing pain and problems associated with these procedures 6 . Misoprostol, on the other hand, has been linked to side effects that include fever, shivering, moderate diarrhoea, nausea, and vomiting 7 .…”

Section: Introductionmentioning

confidence: 99%