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Misoprostol for Women's Health: A Review

Blanchard, Kelly MSc; Clark, Shelley PhD; Winikoff, Beverly MD, MPH; Gaines, Gayle MD; Kabani, Ghazala MHS; Shannon, Caitlin MPH

Reviews

OBJECTIVE To review published literature on misoprostol for women's health indications to provide a synthesis of available information and highlight areas in need of additional research.

DATA SOURCES: Studies were identified through searches of medical literature databases including MEDLINE, Cochrane Database, and Popline, in addition to a review of references from identified articles.

STUDY SELECTION: We included all studies reported in English and published before March 31, 2001, which evaluated the efficacy of misoprostol alone for labor and delivery, evacuation of the uterus after pregnancy failure and induced abortion. Studies were not excluded based on quality or sample size.

TABULATION, INTEGRATION, AND RESULTS: Misoprostol shows promise for all of the women's health indications addressed. Currently available data, though, are often hard to interpret because of variations in regimen, dose, and outcome measures. The low cost, ease of administration and storage, and widespread availability of misoprostol make it particularly appealing for developing countries. Because many of the women's health problems for which misoprostol could be prescribed currently cause significant mortality and morbidity, increased access to and information on use of misoprostol could help improve women's health especially where these problems are most severe.

CONCLUSION Further research is needed to identify optimal regimens for misoprostol for obstetric and gynecologic health indications. Registering misoprostol with national drug regulatory authorities for any of several women's health indications could help increase access to and safe use of this drug. Provider training would be a logical subsequent step.

Misoprostol is effective for the management of a number of women's health indications and could be particularly important in resource-poor settings.

Population Council, Johannesburg, South Africa, and New York, New York.

Address reprint requests to: Kelly Blanchard, MSc, Population Council, One Dag Hammarskjold Plaza, New York, NY 10017; E-mail: kblanchard@pcjoburg.org.za.

We would like to thank the Hewlett Foundation for their support of work on misoprostol for reproductive health indications.

Received December 5, 2000. Received in revised form October 1, 2001. Accepted October 9, 2001.

© 2002 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.