Misoprostol used alone for the termination of early pregnancy. A review of the evidence

Abstract

Increased access to medical methods of abortion could significantly reduce maternal mortality, especially in developing countries. In light of the political and commercial difficulties in distributing the abortifacient mifepristone, the widely studied mifepristone-misoprostol regimen may not be sufficiently available in the near future. Thus, researchers have begun to look for alternative regimens, including regimens using misoprostol alone. This article reviews the current available evidence on the potential of a misoprostol-alone regimen for medical abortion. Although the data are varied and difficult to compare, recent studies indicate that a misoprostol-alone regimen could be safe and effective as a method of medical abortion. Misoprostol is widely marketed around the world for its other indications and is inexpensive, stable in tropical climates, easy to transport, and simple to administer. A misoprostol-alone regimen of medical abortion could thus greatly improve the access to safe medical abortion services by women in developing countries.

PIP: Studies have been conducted to examine the potential of misoprostol alone for early termination of pregnancy. These studies were done by Norman et al. (1991), Creinin and Vittinghoff (1994), Bugalho et al. (1996), Koopersmith and Mishell (1996), Carbonell et al. (two studies: 1997, 1998), and Jain et al. (1998). The designs, population sampling methods and regimens varied from study to study. Thus, comparison of results has been difficult. Overall, though, findings indicate that a misoprostol-alone regimen could be safe and effective as a method of medical abortion. This regimen could greatly improve access to safe medical abortion services for women in developing countries, which in turn would lead to a significant reduction in maternal mortality.