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تعداد آیتم قابل مشاهده باقیمانده : 1 مورد

Misoprostol-only regimens (expert guidelines) for pregnancy termination

Misoprostol-only regimens (expert guidelines) for pregnancy termination
WHO Guideline (2022)[1] FIGO Guideline (2023)[2] SFP Guidelines (2024)[3,4]
Gestational age Misoprostol dosing Gestational age Misoprostol dosing Gestational age Misoprostol dosing
<12 weeks Buccal, intravaginal*, sublingual: 800 mcg <12 weeks Buccal, sublingual, intravaginal*: 800 mcg every 3 hours until expulsionΔ◊ ≤12 weeks Sublingual, intravaginal: 800 mcg every 3 hours for 3 to 4 doses until expulsion
≥12 weeks Buccal, intravaginal*, sublingual: 400 mcg every 3 hoursΔ 13 to 24 weeks Buccal, sublingual, intravaginal*: 400 mcg every 3 hours until expulsionΔ§ 14 0/7 to 23 6/7 weeks Buccal, sublingual, intravaginal: 400 mcg every 3 hours until expulsionΔ
25 to 27 weeks Buccal, sublingual, intravaginal*: 200 mcg every 4 hours until expulsionΔ¥‡ 24 0/7 to 27 6/7 weeks Buccal, intravaginal: 200 mcg every 3 hours until expulsionΔ
≥28 weeks

Intravaginal*: 25 to 50 mcg every 4 hours‡

or

Oral: 50 to 100 mcg every 2 hours‡†
Guidelines recommend a combination regimen of mifepristone followed by misoprostol when possible because it is more effective. Misoprostol should be used with caution in individuals with a prior uterine incision, particularly at advanced gestational ages.

FIGO: International Federation of Gynecology and Obstetrics; SFP: Society of Family Planning; WHO: World Health Organization.

* Avoid intravaginal administration if bleeding and/or signs of infection.

¶ Repeat doses can be used when needed; this guideline does not provide a dosing interval or maximum number of doses.

Δ Repeat doses can be used when needed; this guideline does not provide a maximum number of doses.

◊ Can be self-managed at home.

§ An additional dose should be provided to the patient to use as needed.

¥ Dosing based on Society of Family Planning Guidelines (20111, 20133): A comprehensive systematic review and meta-analysis, published 2020.

‡ Induced fetal demise should be considered for such patients.

† Dosing based on Cochrane Database Systematic Review (CD014484), published 2021.
References:
  1. Abortion care guideline, World Health Organization 2022. Available at: https://apps.who.int/iris/handle/10665/349316 (Accessed on November 10, 2022).
  2. Misoprostol Only Dosing Chart (For use only when mifepristone is not available) Recommended Regimens 2023. International Federation of Gynecology and Obstetrics. Available at: https://www.figo.org/sites/default/files/2023-11/FIGO-Miso-Chart-11-2023%20FINAL.pdf (Accessed March 20, 2024).
  3. Zwerling B, Edelman A, Jackson A, et al. Society of Family Planning Clinical Recommendation: Medication abortion between 14 0/7 and 27 6/7 weeks of gestation: Jointly developed with the Society for Maternal-Fetal Medicine. Am J Obstet Gynecol 2023.
  4. Raymond EG, Mark A, Grossman D, et al. Medication abortion with misoprostol-only: A sample protocol. Contraception 2023; 121:109998.
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