Misoprostol for uterine evacuation in induced abortion and pregnancy failure

Misoprostol – a drug developed and approved originally for the prevention of gastric ulcers – has shown itself to be safe, effective and acceptable for uterine evacuation in the context of induced abortion and failed pregnancy. Many practitioners consider it to be the treatment of choice for these indications, despite the fact that, as of now, nearly all such use remains off-label. In the absence of regulatory guidelines, a great deal of research on misoprostol for uterine evacuation has been conducted – research that both suggests desirable approaches to treatment and highlights areas of continuing uncertainty. It is hoped that summarizing these data can both assist practitioners in their work and spur movement towards optimized regimens and the eventual registration of misoprostol for these uses.