Narrative review on misoprostol for first trimester termination of pregnancy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20231958Keywords:
Abortion, First trimester abortion, Medical termination of pregnancy, MisoprostolAbstract
Misoprostol, a prostaglandin E1 analogue, is first used to prevent peptic ulcers. The first FDA-approved indication in the product labelling is for the prevention and treatment of intestinal ulcer disease caused by the use of nonsteroidal anti-inflammatory medications. The main advantages of misoprostol include it's reasonably priced, compared to other prostaglandins, it has modest effects on the smooth muscle of the heart and bronchial tree and is readily preserved (shelf life: 7 years) and it may be stored and used without refrigeration. Misoprostol has been authorised as an effective medication for termination of pregnancy at different gestations, cervical ripening, labour inducing in term pregnancy, and possibly therapy of postpartum haemorrhage in the last two decades.
References
Potts M, Diggory P. Abortion. Cambridge University Press. 1977.
Singh S, Shekhar C, Acharya R, Moore AM, Stillman M, Pradhan MR, et al. The incidence of abortion and unintended pregnancy in India, 2015. The Lancet Global Health. 2018;6(1):e111-20.
Bankole A, Singh S, Haas T. Characteristics of women who obtain induced abortion: a worldwide review. International Family Planning Perspectives. 1999;25(2):68-77.
Chhabra R. Abortion in India: an overview. Demography India. 1996;25:83-92.
Duggal R, Ramachandran V. The abortion assessment project—India: key findings and recommendations. Reproductive Health Matters. 2004;12(24):122-9.
Sedgh G, Bearak J, Singh S, Bankole A, Popinchalk A, Ganatra B, et al. Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends. The Lancet. 2016;388(10041):258-67.
Khanna AK, Prabhakaran A, Patel P, Ganjiwale JD, Nimbalkar SM. Social, psychological and financial burden on caregivers of children with chronic illness: a cross-sectional study. Indian J Pediatrics. 2015;82(11):1006-11.
Ministry of Health and Family Welfare, Government of India. The Medical Termination of Pregnancy Amendment Act 2002 (No. 64 of 2002). New Delhi: MoHFW. 2002. Available at: https://main.mohfw. gov.in/acts-rules-and-standards-healthsector/acts/ mtp-act-amendment-2002. Accessed on 12 January 2023.
Royal College of Obstetricians and Gynaecologists. The care of women requesting induced abortion. (Evidence-based Clinical Guideline No 7). London: RCOG. 2011. Available at: https://www.rcog.org.uk/ globalassets/documents/ guidelines/abortion-guide line_web_1.pdf. Accessed on 12 January 2023.
Ministry of Law and Justice, Govt of India. The Medical Termination of Pregnancy (Amendment) Act 2021, no 8 of 2021. The Gazette of India. CG-DL-E-26032021-226130. Available at: https://egazette.nic. in/WriteReadData/2021/226130.pdf. Accessed on 12 January 2023.
Yadav M, Kumar A. Medical termination of pregnancy (amendment) act, 2002 an answer to mother's health &'female foeticide'. J Indian Acad Forensic Med. 2005;27(1):0971-3.
Rajagopalan P, Ruggieri D, Johnson J. India's medical termination amendment act of 2014: Pre and post evaluation of quality care. InAPHA 2021 Annual Meeting and Expo. 2021.
Agrawal K. The Medical Termination of Pregnancy (Amendment) Act, 2021: Nominally Progressive or Profoundly Liberal? Jus Corpus LJ. 2020;1:67.
Kulier R, Kapp N, Gülmezoglu AM, Hofmeyr GJ, Cheng L, Campana A. Medical methods for first trimester abortion. Cochrane Database Systemat Rev. 2004(1).
Allen R, O’Brien BM. Uses of misoprostol in obstetrics and gynecology. Rev Obstet Gynecol. 2009;2(3):159.
Barradell LB, Whittington R, Benfield P. Misoprostol. Pharmacoeconomics. 1993;3(2):140-71.
Tang OS, Gemzell-Danielsson K, Ho PC. Misoprostol: pharmacokinetic profiles, effects on the uterus and side-effects. Int J Gynecol Obstet. 2007;99:S160-7.
van Bogaert LJ, Sedibe TM. Efficacy of a single misoprostol regimen in the first and second trimester termination of pregnancy. J Obstet Gynaecol. 2007;27(5):510-2.
Bugalho A, Faundes A, Jamisse L, Usfa M, Maria E, Bique C. Evaluation of the effectiveness of vaginal misoprostol to induce first trimester abortion. Contraception. 1996;53(4):243-6.
Bugalho A, Mocumbi S, Faundes A, David E. Termination of pregnancies of< 6 weeks gestation with a single dose of 800 μg of vaginal misoprostol. Contraception. 2000;61(1):47-50.
Wiebe ER. Misoprostol administration in medical abortion. A comparison of three regimens. J Reprod Med. 2001;46(2):125-9.
Carbonell JL, Varela L, Velazco A, Fernandez C, Sanchez C. The use of misoprostol for abortion at≤ 9 weeks' gestation. Eur J Contracept Reprod Health Care. 1997;2(3):181-5.
Brouns JF, van Wely M, Burger MP, van Wijngaarden WJ. Comparison of two dose regimens of misoprostol for second-trimester pregnancy termination. Contraception. 2010;82(3):266-75.
Dalenda C, Ines N, Fathia B, Malika A, Bechir Z, Ezzeddine S, Hela C, Badis CM. Two medical abortion regimens for late first-trimester termination of pregnancy: a prospective randomized trial. Contraception. 2010;81(4):323-7.
Hamoda H, Ashok PW, Flett GM, Templeton A. A randomised controlled trial of mifepristone in combination with misoprostol administered sublingually or vaginally for medical abortion up to 13 weeks of gestation. BJOG: Int J Obstet Gynaecol. 2005;112(8):1102-8.
Chen QJ, Zhang J, Huang ZR, Fan XF, Wang HY, Hong ZH, et al. Mifepristone in combination with misoprostol for the termination of pregnancy at 8–16 weeks' gestational age: a multicentre randomized controlled trial. J Reprod Contracept. 2013;24(2):101-13.
Khazardoost S, Hantoushzadeh S, Madani MM. A randomised trial of two regimens of vaginal misoprostol to manage termination of pregnancy of up to 16 weeks. Aust N Zealand J Obstet Gynaecol. 2007;47(3):226-9.
Carbonell JL, Rodriguez J, Aragon S, Velazco A, Tanda R, Sanchez C, et al. Vaginal misoprostol 1000μg for early abortion. Contraception. 2001;63(3):131-6.