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BJOG, 2015 k FIGO Guidelines: Treatment of PPH with misoprostol, 2012 1 If mifepristone is available (preferable), follow the regimen prescribed for mifepristone + misoprostola 2 Included in the WHO Model List of cytotec Essential Medicines 3 For incomplete/inevitable abortion women should be treated based on their uterine size rather than last menstrual period (LMP) dating 4 Leave to take effect over 1–2 weeks unless excessive bleeding or infection 5 An additional dose can be offered if the placenta has not been expelled 30 minutes after fetal expulsion 6 Several studies limited dosing to 5 times; most women have complete expulsion before use of 5 doses, but other studies continued beyond 5 and achieved a higher total success rate with no safety issues 7 Including ruptured membranes where delivery indicated 8 Follow local protocol if previous cesarean or transmural uterine scar 9 If only 200μg tablets are available, smaller doses can be made by dissolving in water (see www . org) 10 Where oxytocin is not available or storage conditions are inadequate 11 Option for community based programs Route of Administration pv – vaginal administration cytotec sl – sublingual (under the tongue) bucc – buccal (in the cheek) * Avoid pv (vaginal route) if bleeding and/or signs of infection Rectal route is not included as a recommended route because the pharmacokinetic profile is not associated with the best efficacy .how to administer misoprostol |
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