For medical abortion up to 63 days (9 weeks) gestation, the WHO-recommended regimen involves which combination and dosing?
- A Mifepristone 600 mg orally followed 48 hours later by gemeprost 1 mg vaginally
- B Mifepristone 200 mg orally followed 24–48 hours later by misoprostol 800 mcg vaginally, sublingually, or buccally ✓
- C Methotrexate 50 mg/m² IM followed 5–7 days later by misoprostol 800 mcg vaginally
- D Misoprostol 400 mcg sublingually alone repeated every 3 hours for 3 doses
Explanation
WHO 2022 abortion care guidelines recommend mifepristone 200 mg orally (not 600 mg — 200 mg is equally effective with lower side effects) followed by misoprostol 800 mcg (via vaginal, sublingual, or buccal route) 24–48 hours later for medical termination up to 63 days gestation. This combination achieves complete abortion in >95% of cases. Sublingual route has faster absorption but more systemic side effects (fever/chills). Gemeprost has been replaced by misoprostol due to cost and availability. Methotrexate + misoprostol is a valid alternative but less commonly used when mifepristone is available.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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Written and medically reviewed by the StethoPrep medical team.