Objective: We reviewed published literature on misoprostol for reproductive health indications to provide a synthesis of available information and highlight areas in need of additional research. Studies were identified through searches of medical literature databases including MEDLINE and review of references from identified articles. All studies published prior to Dec 31, 1999 in English that evaluated the efficacy of misoprostol alone for cervical ripening/labor induction, treatment or prevention of postpartum hemorrhage, cervical ripening prior to surgical abortion, treatment of incomplete or missed abortion and induction of abortion in the second trimester were included. Studies were not excluded based on quality or sample size. Efficacy, side effects, and regimen reported were evaluated.
Results: Misoprostol shows promise for all the reproductive health indications addressed. Currently available data, though, are often hard to interpret due to variations in regimen, dose, and outcome measures. The low cost, ease of administration and storage, and wide availability of misoprostol make it appealing for developing countries. In addition, since many of the reproductive health problems for which misoprostol could be prescribed are causes of significant mortality and morbidity, increased access to and information on use of misoprostol could help reduce maternal mortality and morbidity particularly where these problems are most severe.
Conclusion: Further research is needed to identify optimal regimens for misoprostol for reproductive health indications. Registering misoprostol with drug regulatory authorities for any of several reproductive health indications could increase access and safe use of this drug. Appropriate labeling and provider training are concomitant next steps.
Learning Objectives: N/A
Keywords: Reproductive Health,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.