title: Misoprostol use in obstetrics and gynecology in Brazil, Jamaica, and the United States.
abstract: OBJECTIVE
  To investigate current clinical use of misoprostol for the treatment of a range of reproductive health indications by providers in Brazil, Jamaica, and the United States.
  
  
  METHODS
  Using a 'snowball' sampling technique, we surveyed 228 gynecologists and obstetricians in Brazil (n=123), Jamaica (n=52), and the United States (n=53).
  
  
  RESULTS
  Providers use misoprostol for labor induction (46%), postpartum hemorrhage (8%), intra-uterine fetal death (61%), cervical priming (21%), missed abortion (57%), and incomplete abortion (16%) as well as first and second trimester abortion induction (27% and 13%, respectively).
  
  
  CONCLUSIONS
  There is considerable variation in the regimens used; moreover, the regimens commonly used in clinical practice often differ from those recommended in the medical literature. While misoprostol is an appealing alternative for many reproductive health indications in developing countries, the varied regimens and lack of registration raise critical medical and policy questions.
authors.affiliation: Population Council, New York, NY 10017, USA.
authors.forename: S
authors.initials: S
authors.lastname: Clark
authors.forename: J
authors.initials: J
authors.lastname: Blum
authors.forename: K
authors.initials: K
authors.lastname: Blanchard
authors.forename: L
authors.initials: L
authors.lastname: Galvão
authors.forename: H
authors.initials: H
authors.lastname: Fletcher
authors.forename: B
authors.initials: B
authors.lastname: Winikoff
mesh_terms: D001938:Brazil; D003625:Data Collection; D005260:Female; D005831:Genital Diseases, Female / Q000188:drug therapy*; D006801:Humans; D007563:Jamaica; D008297:Male; D016595:Misoprostol / Q000008:administration & dosage* / Q000627:therapeutic use*; D010120:Oxytocics / Q000008:administration & dosage* / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D014481:United States
chemical_list: D010120:Oxytocics; D016595:Misoprostol