Hourly Oral Misoprostol Administration for Terminating Midtrimester Pregnancies: A Pilot Study

Abstract

Our preliminary results show that oral administration of misoprostol at hourly intervals is a promising method for terminating midtrimester pregnancies.

Pharmacokinetic Analysis of Hourly Oral Misoprostol Administration – A Pilot Study

“…Because MPA is responsible for its clinical activity with a peak serum concentration after oral misoprostol administration of 34 minutes and a half-life of 20-40 minutes [14], only plasma concentration of misoprostol acid need to be detected. A pharmacokinetic analysis of misoprostol was previously performed for a single dose of 400 μg via five different routes: 1) Sublingual, 2) Oral, 3) Vaginal, and 4) Vaginal of China Medical University Hospital and Beigang Hospital, and was granted from Dec 08, 2010 to Dec 07, 2011 at the Departments of Obstetrics and Gynecology.…”

“…In one pilot study, small, frequent (every 2 hours), titrated doses of oral misoprostol minimized the risk of uterine hyperstimulation and prevented fetal hypoxia [11,12]. Investigators developed an advanced approach with hourly oral misoprostol administration relative to uterine response for labor induction or augmentation at term or for terminating mid-trimester pregnancies [4,[13][14][15][16][17]; they achieved a high rate of success within 24 hours. According to the results of titration studies, misoprostol is an ideal candidate for labor induction and augmentation due to its convenience of administration and cervical ripening characteristics.…”

Medical and Surgical Induced Abortion

“…Fekih et al, (2010) used a regimen of sublingual misoprostol 800mcg four hourly to a maximum of three doses with a success rate of 92.1%. Cheng et al, (2010) have reported a 100% success rate in terminating second trimester pregnancies with oral misoprostol alone www.intechopen.com given at doses of 200 mcg/hr for the first 12 hours and 400 mcg/hr after 12hours until delivery; the most common side effect was diarrhoea, which was easily relieved by medication. This paper illustrates the safety of higher doses of misoprostol than previously used, with a much higher success rate that should be replicable in the first trimester.…”

“…Cheng et al, (2010) have reported a 100% success rate in gestation up to 25 weeks with a regimen of oral misoprostol given in a dose of 200 mcg hourly for the first 12 hours and 400 mcg hourly after 12 hours www.intechopen.com until delivery. The median induction to delivery interval was 12.0 hours, with a range of 6.3 to 30.9 hours.…”

Evaluating misoprostol content in pregnant women with hourly oral administration during labor induction by microElution solid phase extraction combined with liquid chromatography tandem mass spectrometry

“…Several published case reports [8,9,10] ing of misoprostol with single dosage more than 3.0 mg resulted in hyperthermia, hypoxia and rhabdomyolysis. In previous clinical pilot study [11], the maximum total dosage was 9.6 mg in nulliparous woman who only experienced the diarrhea and it is the most common side effect (50%) in the study. Because of recommended therapeutic dose is low, the highest concentration of the bioactive metabolite is very low [12].…”