Dosage of Misoprostol (Cytotec) abortion pill after 12 week of pregnancy

These recommendations for Misoprostol (Cytotec) as abortion pills were produced by a WHO (World Health Organization) expert group in Bellagio, Italy in Feb 2007. These recommendations do not reflect official WHO guidelines because studies of use Misoprostol (Cytotec) as abortion pill is not completed and still continue.

The full text of this material issued by A. Faúndes, C. Fiala, OS. Tang, A. Velasco and named "Misoprostol for the termination of pregnancy with a live fetus at 13 to 26 weeks" in International Journal of Gynaecology and Obstetrics, 2007, 99-supp 2. The english language original as read-only pdf file can be found here. Adobe Acrobat need for view pdf documents.

For termination unwanted 13 to 22 week pregnancy with Misoprostol (Cytotec) alone you have to take Misoprostol (Cytotec):

vaginally of 400mg repeated up to 5 times at 3 hours interval

 

Case of 13-22 weeks

Woman have to take 400mg of Misoprostol (Cytotec) vaginally every 3 hours up to 5 doses. Further doses of pills do not need if abortion complete (fetus and placenta complete expulse).

Comparing randomized trials "oral versus vaginal" use of Misoprostol (Cytotec) showed that vaginal use of Misoprostol (Cytotec) is more effective than oral use of Misoprostol (Cytotec). In case of the vaginal use incidence of side effects is also lower than oral use. The oral sublingual administration of Misoprostol (Cytotec) may be compared with vaginal use of Misoprostol (Cytotec) but it appeared to be less effective for this period of pregnancy.

There are many regimens of use Misoprostol (Cytotec) reported in the literature with apparently good results. The regimen described above have been found to be the most effective without excessive side effects or complications. Lower doses of Misoprostol (Cytotec) or less frequent pills administration are also acceptable with longer intervals.

Case of 23-26 weeks

Currently not enough adequate data to make any recommendations on the dosage and regimen for termination of pregnancy between 23 to 26 weeks use Misoprostol (Cytotec) alone. With increasing gestational age (duration time of pregnancy) the uterus becomes more sensitive to prostaglandins, so dosage need to be reduce.

The possibility of heavy vaginal bleeding and serious complications is high. Woman with 23-26 weeks of pregnancy wanted to cancel pregnancy have to have abortion in health care facility (hospital or clinic) where available blood transfusion and access to emergency surgery.

After such abortion, the woman should be observed in the clinic for at least 4 hours to monitor her health condition and the amount of vaginal bleeding.

All women should be followed up about two weeks after the abortion during the recovery period for the amount of vaginal bleeding and existence of any signs of infection.