WHO recommendations for misoprostol use for obstetric and gynecologic indications

Tang, Jennifer H.; Kapp, Nathalie; Souza, João Paulo

doi:10.1016/j.ijgo.2012.12.009

Cited by 115 publications

(95 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The cervical ripening effect of misoprostol by different routes of administration has been demonstrated in labor, abortion induction and hysteroscopy [12,13,14]. Only a few studies have evaluated the use of misoprostol administered via different routes for women undergoing dilation and curettage.…”

Section: Introductionmentioning

confidence: 99%

Vaginal Misoprostol versus a Rectal Nonsteroidal Anti-Inflammatory Drug to Reduce Pain during Pipelle Endometrial Biopsies: A Prospective, Randomized, Placebo-Controlled Trial

Telli

Aydın²,

Öge

et al. 2014

Gynecol Obstet Invest

View full text Add to dashboard Cite

Background: To evaluate and compare the efficacy of vaginal misoprostol and a rectal nonsteroidal anti-inflammatory drug (NSAID) on pain relief during Pipelle endometrial biopsies in a placebo-controlled randomized study. Methods: One hundred and fifty-one women who had an indication for a Pipelle endometrial biopsy were randomized into three groups as follows: group 1, vaginal misoprostol; group 2, rectal NSAID, and group 3, control. After the procedure, the women were asked to record their pain severity on a visual analog scale. The secondary outcome of the study was patient acceptability, and vasovagal symptoms and analgesic requirements after the procedure were also recorded. Results: There were no statistically significant differences in the demographic characteristics of the patients. The primary study outcome was the comparison of the median visual analog scale pain scores of groups 1 and 2 versus group 3 (controls); no statistically significant differences were found (p = 0.502). In addition, the patient acceptability (Likert scale), vasovagal symptoms and analgesic requirements after the procedure were similar among the groups (p = 0.204, 1 and 0.546, respectively). Conclusion: Our study did not demonstrate a reduction in pain relief during Pipelle endometrial biopsies for patients receiving vaginal misoprostol or a rectal NSAID when compared to patients receiving placebo treatment.

show abstract

Section: Introductionmentioning

confidence: 99%

Vaginal Misoprostol versus a Rectal Nonsteroidal Anti-Inflammatory Drug to Reduce Pain during Pipelle Endometrial Biopsies: A Prospective, Randomized, Placebo-Controlled Trial

Telli

Aydın²,

Öge

et al. 2014

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…Misoprostol can be applied by various routes and at various doses [6,12,24]. Because of its efficacy, cost-effectiveness, easy storage at room temperature and easy administration, misoprostol is listed as an essential medication by the World Health Organization [25,29,30].…”

Section: Introductionmentioning

confidence: 99%

Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol

Kreft

Krähenmann

Roos

et al. 2014

Journal of Perinatal Medicine

View full text Add to dashboard Cite

Aim: To compare the efficacy and safety of two misoprostol dosing regimens for induction of labour in primiparous (1P) and multiparous ( > 1P) women. Methods: Retrospective study of induction of labour using vaginal misoprostol 25 μg vs. 50 μg every 6 h in 942 women at a tertiary centre. The main outcome variables are induction-to-delivery interval, latency period duration, vaginal delivery within 24 h, and maternal and foetal safety outcome. Results: With the 50 μg regimen, induction-to-delivery intervals were significantly shorter: 18.4 h vs. 24.6 h (1P) and 14 h vs. 17.9 h ( > 1P), as was latency period duration (by 5.4 and 4 h, respectively). Vaginal delivery within 24 h was significantly more frequent, as were non-reassuring foetal heart rate (1P: 20% vs. 14%) and tachysystole (1P: 31% vs. 11%; > 1P: 21% vs. 7%). No uterine rupture was reported. Neonatal outcomes were similar except for significantly more frequent infant referral to neonatal intensive care in the > 1P group receiving the 50 μg regimen (11% vs. 4%). Conclusion: Vaginal misoprostol 25 μg seems to maintain efficacy with more acceptable maternal and neonatal safety. As induction of labour is an off-label use for misoprostol, safety should be prioritised with the lower dosage regimen despite the longer induction-to-delivery interval.

show abstract

“…All studies have concluded that it is an effective medication for this indication [10][11][12]. WHO recommends that cervical ripening with misoprostol should have a maximum duration of 24 h [31]. To our knowledge, there is no study reporting on the incremental benefice of each additional misoprostol tablet and therefore on the optimal duration of misoprostol treatment for cervical ripening.…”

Section: Discussionmentioning

confidence: 99%

What is the optimal duration of oral misoprostol treatment for cervical ripening?

Drakopoulos

Duyck

Gayet-Ageron

et al. 2016

The Journal of Maternal-Fetal & Neonatal Medicine

View full text Add to dashboard Cite

Objectives: To evaluate the number of misoprostol tablets needed to obtain a Bishop score (BS) 6 or a significant cervical change ( 2 points in BS) during cervical ripening. Methods: Retrospective study of women with term singleton pregnancies and a BS56 taking oral misoprostol (20 mg first 2 doses followed by 40 mg every 2 h) for cervical ripening. Results: We included 400 women, 72% nulliparous, mean age of 31.3 ± 5.9 years and 70% with a baseline BS 2. During cervical ripening, 61 (15.3%) achieved a BS 6 and 205 (51.3%) a significant change in BS. The incremental risk to achieve a BS 6 after 4 tablets was low (+3.25%) with an incremental probability of +12.75% for painful uterine contractions and +0.5% for abnormal fetal tracing (AFT). The incremental probability to achieve a significant change in BS after 7 tablets was low (+2.0%). 24.3% women delivered by cesarean section which likelihood significantly increased with maternal age 535 years, BMI 30, nulliparity, AFT, and baseline BS 2. Conclusions: The marginal benefit of giving more than 7 misoprostol tablets (14 h) during cervical ripening is very low.

show abstract

WHO recommendations for misoprostol use for obstetric and gynecologic indications

Abstract: 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.

Cited by 115 publications

References 13 publications

Vaginal Misoprostol versus a Rectal Nonsteroidal Anti-Inflammatory Drug to Reduce Pain during Pipelle Endometrial Biopsies: A Prospective, Randomized, Placebo-Controlled Trial

Vaginal Misoprostol versus a Rectal Nonsteroidal Anti-Inflammatory Drug to Reduce Pain during Pipelle Endometrial Biopsies: A Prospective, Randomized, Placebo-Controlled Trial

Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol

What is the optimal duration of oral misoprostol treatment for cervical ripening?

Contact Info

Product

Resources

About