A woman at 9 weeks gestation requests medical termination of pregnancy. She has no contraindications. What is the WHO-recommended protocol for medical abortion?
- A Misoprostol 800 mcg vaginally alone, repeated every 3 hours for 3 doses
- B Mifepristone 200 mg orally followed 24–48 hours later by misoprostol 800 mcg sublingually or vaginally ✓
- C Mifepristone 600 mg orally followed 72 hours later by misoprostol 400 mcg orally
- D Methotrexate 50 mg/m² IM followed 3–7 days later by misoprostol 800 mcg vaginally
Correct answer: B. Mifepristone 200 mg orally followed 24–48 hours later by misoprostol 800 mcg sublingually or vaginally
Explanation
The WHO-recommended regimen for medical abortion up to 12 weeks is mifepristone 200 mg orally (an antiprogestogen) followed after 24–48 hours by misoprostol 800 mcg administered sublingually or vaginally. Mifepristone 600 mg is an older, higher dose regimen. Misoprostol alone is effective but less so than the combination. The combination has a success rate >95% for complete abortion. Methotrexate–misoprostol is used in countries where mifepristone is unavailable, with a lower efficacy profile.
Reference: Williams Obstetrics, 26th ed.
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Written and medically reviewed by the StethoPrep medical team.