Q: Misoprostol is a synthetic Prostaglandin analogue (PGE1) used an oral preparation to prevent and treat gastrointestinal mucosal damage induced by NSAIDs. What are its indications in the acute care of obstetrics and gynecology?
Answer: Misoprostol increases uterine tone and hence decreases postpartum hemorrhage (PPH). Misoprostol alone is about 75-85% successful in inducing termination of pregnancy during the first trimester of pregnancy. With Mifepristone this efficacy increases when used as recommended. Another indication for its use is for cervical ripening before surgical procedures like DnC (Dilation and Curettage). Due to its wide-ranging applications in reproductive health, Misoprostol is on the WHO Model list of essential medicines. Its advantages over other synthetic prostaglandins are its low cost, long shelf life, lack of need for refrigeration, and worldwide availability.
Allen R, O'Brien BM. Uses of misoprostol in obstetrics and gynecology. Rev Obstet Gynecol. 2009;2(3):159‐168.