Misoprostol in gynecology.
Misoprostol is an important medication for gynecologic practice; however, it is not approved by the US Food and Drug Administration for any gynecologic indication. Evidence-based practice must guide our use of this important drug. Its use for medical abortion in conjunction with mifepristone or methotrexate is supported by a large body of high-quality evidence. There is also a rapidly growing amount of literature on the use of misoprostol for the management of miscarriage; however, more research is needed to optimize use. Solid evidence supports the efficacy of misoprostol for cervical ripening before first-trimester suction curettage abortion, and good evidence supports its use before hysteroscopy in premenopausal women; however, complications are rare with these procedures, making it difficult to assess any impact on complication rates. Most studies have not demonstrated a benefit for using misoprostol as a cervical ripening agent in postmenopausal women.
Goldberg
Alisa B
AB
Planned Parenthood League of Massachusetts, 1055 Commonwealth Avenue, Boston, MA 02215, USA. alisa_Goldberg@pplm.org
Carusi
Daniela A
DA
Meckstroth
Karen R
KR
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000592:standards; D000029:Abortion, Legal / Q000379:methods; D000022:Abortion, Spontaneous / Q000188:drug therapy / Q000517:prevention & control; D020070:Cervical Ripening / Q000187:drug effects; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects / Q000592:standards; D010120:Oxytocics / Q000008:administration & dosage / Q000009:adverse effects / Q000592:standards; D011247:Pregnancy; D014481:United States; D014486:United States Food and Drug Administration; D016387:Women's Health
D000020:Abortifacient Agents, Nonsteroidal; D010120:Oxytocics; D016595:Misoprostol