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Misoprostol as a single agent for medical termination of pregnancy

Caitlin Shannon, MPH
Beverly Winikoff, MD, MPH
Section Editor
Jody Steinauer, MD, MAS
Deputy Editor
Sandy J Falk, MD, FACOG


Medical methods for induced abortion have emerged over the past two decades as safe, effective, and feasible alternatives to surgery. Nonsurgical alternatives expand a woman's treatment options and, in turn, the quality of care [1]. Moreover, in some settings, surgical options are not available to women or are not medically feasible.

In first trimester abortion, combined treatment with misoprostol with mifepristone appears to be more effective than misoprostol-alone regimens, and thus, are considered the gold standard for medical induction [2,3]. However, misoprostol-alone regimens may be the treatment of choice in settings in which mifepristone is not available or is too costly.

Misoprostol is commonly used as a single agent for second trimester induced abortion in the United States and many other parts of the world [4,5].

This topic review will discuss use of misoprostol in pregnancy termination. Use of mifepristone and other medical and surgical approaches to pregnancy termination and use of misoprostol for fetal demise or labor induction are reviewed separately. (See "First-trimester medication abortion (termination of pregnancy)" and "Overview of pregnancy termination" and "Spontaneous abortion: Management" and "Fetal death and stillbirth: Incidence, etiology, and prevention" and "Techniques for ripening the unfavorable cervix prior to induction".)


Misoprostol is a synthetic E1 prostaglandin (PGE1) developed and approved originally for the prevention of gastric ulcers. Misoprostol is not approved by the United States Food and Drug Administration for uterine evacuation in pregnant women.


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Literature review current through: Sep 2016. | This topic last updated: Jul 28, 2014.
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