Misoprostol At 2 Weeks Pregnancy Dosage

The purpose of this study was to evaluate the efficacy, safety and acceptability of 800 microg misoprostol as compared with 600 microg every 8 h for 24 h as an abortifacient in an indigent population. The mean gestational age at the time of conception was 2.5 wk. The failure rate was 4%, which is statistically similar to a previous report (7%),18 indicating that it is a reliable method for inducing early abortion in women who have not undergone any prior medical treatment for unwanted pregnancy (Table 2).

Misoprostol, 800 micrograms every 8 hr for 24 hr, between 7th and 9th week of gestation is a valid method of abortion

misoprostol is a prostaglandin E1 analogue which induces uterine contractions, cervical softening and dilatation. The purpose of this study was to evaluate the efficacy and safety of misoprostol compared with a placebo in women who were at 17-21 weeks gestation and diagnosed as having uncomplicated elective surgical abortion under local anaesthesia

According to the results obtained, 800 microg of misoprostol administered every 8 h for 24 h could be a valid method for abortion for up to 9 weeks of gestation. But abortion at the end of 9 weeks depends on several factors: the number of Gestations achieved at this period, the gestational age and possible complications from abortion procedures which may cause foetal death

According to the results obtained, 800 microg of misoprostol administered every 8 h for 24 h could be a valid method for abortion for up to 9 weeks of pregnancy; however, it is less efficient than mifepristone+misoprostol regimen. This can be justified by the fact that in women who received 800 microg of misoprostol every 8 h, there was not significant difference between the number of days before expulsion and those after 7 hours (9.0 ± 5.0 days); this suggests an increase in delay compared with that observed in patients receiving 600 microg every 4 h (7.9 ± 4.8 days). These results seem well correlated with the findings of other studies comparing regimens of misoprostol alone or combined with mifepristone: Urdaneta-Vega et al., [4] reported that each 400 μg dose used once a day both at day 3 or 6 after mifepristone induces abortion within 12 +/- 5 days in 86% of cases, whereas Duenas et al., [6] found that when 600 μg are taken each 4 h for two consecutive doses on day 1, then 200 μg every 8 h on days 2–

How Many Tablets of Misoprostol Should Be Inserted

The objective of the study was to evaluate the efficacy and safety of 800 microg misoprostol (Cytotec) every 8 h for 24 h for pharmacological abortion; the treatment was repeated if abortion did not occur in the first 24-h interval. The first misoprostol doses were always self-administered into the vagina; the second and third doses could be administered orally or vaginally depending on the amount of bleeding. Four-hundred and fifty-two women with gestations between 36 and 63 days were recruited into the study. The main outcomes assessed were: successful abortion (complete abortion without surgery), side effects, mean drop in hemoglobin, vaginal bleeding and mean time of return of menstruation. Complete abortion occurred in 409/452 (90.5%; 95% confidence interval [CI] 87%, 93%) patients. Medication to relieve symptoms was administered to all women before the first misoprostol dose. Vaginal bleeding lasted 15.9 +/- 4.4 days. The mean drop in hemoglobin, measured 14 days after abortion, was statistically significant (p = 0.0001) but without clinical relevance. According to the results obtained, 800 microg of misoprostol administered every 8 h for 24 h could be a valid method for abortion for up to 9 weeks of gestation.

The clinical data indicated that 800 microg of misoprostol administered every 8 h for 24 h could be a valid method for abortion up to 9 weeks from sexual intercourse.

Misoprostol at 2 weeks pregnancy dosage is a good choice for women who want to induce the abortion process. By using this method, you can ensure that your baby dies within few days, and you will not be pregnant anymore.

Misoprostol, a prostaglandin derivative with uterotonic and abortifacient activity, has been used as an abortifacient in combination with mifepristone (RU486). Misoprostol has been effectively used for early medical abortion using a dose of 400 microg orally every 6 h for 12 h along with mifepristone. With the objective of developing a protocol for medical abortion up to 9 weeks gestation, a prospective randomized open-label study was carried out on 120 women during first trimester. A total of 800 microg misoprostol were administered every 8 h for 24 h. Outcome measures were successful expulsion within 24 h of last dose, manual vacuum aspiration and failure rate.

In this study, we have found that 800 microg of misoprostol administered every 8 h for 24 h could be a valid method for abortion for up to 9 weeks of pregnancy and up to 63 days after conception.

When Can I Take My Second Dose Of Misoprostol

  • Up to 10 weeks gestation (70 days since last menstrual period (LMP)): Mifepristone 200mg orally followed 1-2 days later by misoprostol 800mcg buccally, sublingually or vaginally.
  • 10-13 weeks gestation: Following mifepristone, women typically require two doses of misoprostol for a successful abortion.
    • Mifepristone 200mg orally followed 1-2 days later by either misoprostol 600mcg sublingually or 800mcg vaginally, then 400mcg sublingually or vaginally every three hours until expulsion.
    • Alternatively, mifepristone 200mg orally followed 1-2 days later by misoprostol 800mcg buccally, sublingually or vaginally may be used; the dose of misoprostol may be repeated to achieve abortion success.

Strength of recommendation: Strong

Quality of evidence:

  • Up to 10 weeks gestation: High
  • 10-13 weeks gestation: Low

Up to nine weeks (63 days since LMP)

Multiple randomized controlled clinical trials have shown that the combination of mifepristone and misoprostol
is an effective medical abortion regimen with success rates ranging from 95-98% up to nine weeks gestation (Abubeker et al, 2020; Chen & Creinin, 2015; Kapp, Baldwin, & Rodriguez, 2018; Kulier et al., 2011; Raymond, Shannon, Weaver, & Winikoff, 2012). Vaginal, buccal and sublingual misoprostol are more effective than oral misoprostol (Kulier et al., 2011). Buccal dosing (Middleton et al., 2005) and sublingual dosing (Tang, Chan, Ng, Lee, & Ho, 2003; von Hertzen et al., 2010) have higher rates of gastrointestinal side effects than vaginal dosing. Sublingual dosing is associated with more side effects than buccal dosing (Chai, Wong, & Ho, 2013). Decreasing the sublingual misoprostol dose to 400mcg decreased side effects but increased the rates of incomplete abortion and ongoing pregnancy (Bracken et al., 2014; Raghavan et al., 2013; von Hertzen et al., 2010); therefore, the recommended dose of sublingual misoprostol remains 800mcg. Buccal or sublingual dosing may be preferred over vaginal dosing to accommodate women’s preferences or legal restrictions.

Simultaneous dosing of mifepristone and misoprostol in women with gestations up to 63 days has demonstrated a success rate of approximately 95%, compared to 97-98% when misoprostol is used 24-48 hours after mifepristone (Creinin et al., 2007; Goel, Mittal, Taneja, Singal, & Attri, 2011; Lohr, Starling, Scott, & Aiken, 2018). Although this method is slightly less effective, it may be preferable in certain settings, such as where home use of medical abortion drugs is restricted (Lohr et al., 2018).

9-10 weeks (64-70 days since LMP)

A 2015 review reports data from five comparative studies including 801 women with gestations between 64-70 days and 1,163 with gestations from 57-63 days (Abbas, Chong, & Raymond, 2015). In four studies, women received 200mg mifepristone followed by 800mcg buccal misoprostol (Boersma, Meyboom-de Jong, & Kleiverda, 2011; Pena et al., 2014; Sanhueza Smith et al., 2015; Winikoff et al., 2012) and in one study, women received mifepristone and 400mcg sublingual misoprostol (Bracken et al., 2014). There was no difference in success rates between the two gestational groups (93.9% at 57-63 days compared to 92.3% at 64-70 days). Further, there were no differences in serious adverse events, such as hospital admissions or transfers, between the groups (0.7% and 0.5% respectively). One observational study included in the review reported an abortion success rate of 94.5% from 9-10 weeks when women used a regimen of mifepristone followed by 800mcg of vaginal misoprostol (Gouk et al., 1999). Additional studies published since this review using sublingual (Platais, Tsereteli, Grebennikova, Lotarevich, & Winikoff, 2016) or buccal misoprostol (Tan et al., 2018) after mifepristone have shown similar success rates for the gestational age range from 9-10 weeks.

10-13 weeks

A retrospective cohort study of 1,076 women showed that a combination of 200mg mifepristone followed 36-48 hours later by misoprostol (800mcg vaginally or 600mcg sublingually), and then repeated doses of 400mcg misoprostol vaginally or sublingually every three hours for two additional doses is safe and effective between 9-13 weeks (Hamoda, Ashok, Flett, & Templeton, 2005). All women took misoprostol in the health facility. The success rate for this regimen was high at 95.8%, with a low rate of serious adverse events. A smaller trial randomized 211 women with pregnancies between 9-13 weeks to either the vaginal or sublingual route of misoprostol administration described above; all women received pretreatment with mifepristone (Hamoda, Ashok, Flett, & Templeton, 2005a). In both groups, women typically required 2 doses of misoprostol to have a successful abortion; 3.4% of women in the vaginal group required surgical evacuation of the uterus, compared to 2.9% in the sublingual group. Women in the sublingual group were more likely to experience side effects. A  prospective cohort study (Lokeland et al., 2010) including 254 women reported an abortion success rate of 91.7% using a similar regimen. A small prospective cohort study examined effectiveness of mifepristone 200mg orally followed 36-48 hours later by misoprostol 800mcg vaginally as a single dose (Gouk et al., 1999), and found a success rate of 95% among 126 women with pregnancies between 70-83 days. A prospective, open-label, non-inferiority trial compared the efficacy of a medical abortion regimen of 200mg mifepristone followed by a single dose of 800mcg misoprostol in 362 women at 64-70 days gestation to efficacy of the same regimen in 286 women from 71-77 days gestation (Dzuba et al., 2020). The expulsion rate was 92% in the 64-70 day group, with an ongoing pregnancy rate of 4%, compared to 87% and 9% in the 71-77 day group, leading investigators to conclude that an abortion regimen with a single dose of misoprostol after 70 days is less effective. A 2018 systematic review of medical abortion in the late first trimester concluded that abortion success rates are higher when routine, repeated doses of misoprostol are used and when the vaginal route is used over oral administration (Kapp, Eckersberger, Lavelanet, & Rodriguez, 2018).

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