A 32-year-old with 9 weeks of amenorrhoea and confirmed intrauterine pregnancy chooses medical abortion. The optimal regimen for medical abortion up to 9 weeks in India is:
- A Methotrexate 50 mg/m² IM followed by misoprostol 800 mcg after 3–7 days
- B Mifepristone 200 mg oral followed 24–48 hours later by misoprostol 800 mcg vaginally/sublingually ✓
- C Misoprostol 800 mcg alone vaginally repeated every 3 hours for 3 doses
- D Mifepristone 600 mg on day 1 followed by misoprostol 400 mcg orally on day 3
Correct answer: B. Mifepristone 200 mg oral followed 24–48 hours later by misoprostol 800 mcg vaginally/sublingually
Explanation
The WHO-recommended and FOGSI-endorsed regimen for medical abortion up to 9 weeks (63 days) is mifepristone 200 mg orally followed 24–48 hours later by misoprostol 800 mcg administered vaginally, sublingually, or buccally. This combination achieves complete abortion in ~96–98% of cases. The original regimen used 600 mg mifepristone, but 200 mg is equally effective and is now the standard dose. Misoprostol alone has lower efficacy (~80%). Methotrexate-misoprostol is used for ectopic pregnancy management, not routine medical abortion in India.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.